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Ask Suicide-Screening Questions (ASQ)

See: Emergency Department Suicide Screening Tool Accurately Predicts At Risk Youth.

See also: Printable PDF version of this tool

Ask Suicide-Screening Questions

Suicide Risk Screening Tool

NIMH Toolkit

Ask the patient:

  1. In the past few weeks, have you wished you were dead?
    Yes
    No

  2. In the past few weeks, have you felt that you or your family would be better off if you were dead?
    Yes
    No

  3. In the past week, have you been having thoughts about killing yourself?
    Yes
    No

  4. Have you ever tried to kill yourself?
    Yes
    No

    If yes, how?


    When?


    If the patient answers Yes to any of the above, ask the following acuity question:

  5. Are you having thoughts of killing yourself right now?
    Yes
    No

Next steps

  • If patient answers “No” to all questions 1 through 4, screening is complete (not necessary to ask question #5). No intervention is necessary (*Note: Clinical judgment can always override a negative screen).

  • If patient answers “Yes” to any of questions 1 through 4, or refuses to answer, they are considered a positive screen. Ask question #5 to assess acuity:

    • “Yes” to question #5 = acute positive screen (imminent risk identified)
      • Patient requires a STAT safety/full mental health evaluation.
        Patient cannot leave until evaluated for safety.
      • Keep patient in sight. Remove all dangerous objects from room. Alert physician or clinician responsible for patient’s care.

    • “No” to question #5 = non-acute positive screen (potential risk identified)
      • Patient requires a brief suicide safety assessment to determine if a full mental health evaluation is needed. Patient cannot leave until evaluated for safety.
      • Alert physician or clinician responsible for patient’s care.

Provide resources to all patients

  • 24/7 National Suicide Prevention Lifeline 1-800-273-TALK (8255) En Español: 1-888-628-9454
  • 24/7 Crisis Text Line: Text “HOME” to 741-741

asQ Suicide Risk Screening Toolkit - National Institute of Mental Health - 5/4/2017