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Intramural Researchers Develop Suicide Risk Screening Toolkit for Medical Settings

Download the toolkit at

Science Update

Researchers in the National Institute of Mental Health (NIMH)’s Division of Intramural Research Programs (IRP) developed and recently shared a free resource—the Ask Suicide-Screening Questions (ASQ) toolkit. This toolkit includes a set of screening questions that can help nurses or physicians in medical settings successfully identify youth at risk for suicide.

Suicide is a major public health concern in the United States. In 2015, more than 5,900 youths between the ages of 10 and 24 died by suicide  according to the Centers for Disease Control and Prevention (CDC). Even more common than death by suicide are suicide attempts and suicidal thoughts. Early detection is a critical prevention strategy, according to Dr. Lisa M. Horowitz, Ph.D., M.P.H., an NIMH IRP clinician and researcher who led the development of the toolkit. Emergency departments, inpatient medical/surgical unit, and outpatient primary care and specialty clinics offer a promising opportunity for suicide screening and intervention.

“Many families use the emergency department as their sole contact in the health care system,” said Dr. Horowitz. “Most people don’t show up to the emergency department and say, ‘I want to kill myself.’ They show up with physical complaints and will most likely not discuss their suicidal thoughts unless they are asked directly. Nurses and physicians need to know what questions to ask to identify the patients at risk.”

The ASQ is a set of four screening questions that takes 20 seconds to administer. In a study by the NIMH IRP researchers who developed the ASQ and the toolkit, a “yes” response to one or more of the four questions identified 97% of youth (aged 10 to 21 years) at risk for suicide. The toolkit is organized by the medical setting in which it will be used: emergency departments, inpatient medical/surgical units, and outpatient primary care and specialty clinics.

“Each setting needs to have a plan in place to manage patients that screen positive,” Dr. Horowitz explained. “The ASQ toolkit will help with suicide risk screening, but also provides tools for the management of patients who are found to be at risk.”

The ASQ is free of charge and available in multiple languages, including Spanish, Portuguese, French, Arabic, Dutch, Hebrew, Mandarin, and Korean. To learn more or download the toolkit, visit