Let's Talk:

Screening for Suicide
in Varied Settings

We've presented information about a continuum of care for suicide. Here we'll focus on screening.
A continuum of care includes:

Information About Screening

  • Screening for suicide typically involves use of a standardized tool. Depressed man speaking to a therapist while she is taking notes
  • Screening is used to identify people who need a more thorough assessment of suicide risk.
  • Universal screening refers to screening everyone in a population.
    • For example, a primary care practice may screen everyone for suicide at annual physicals.
  • Selective screening programs are targeted toward only those people in a population who may have a higher risk for suicide.
    • For example, a primary care practice may screen only people being treated for a mental health or substance use disorder.
  • Screening for suicide can occur in:
    • Primary Care Offices
    • Emergency Departments
    • Behavioral Health Settings
    • Medical/Surgical Inpatient Settings
  • There is insufficient data, and some disagreement, about whether different types of healthcare sites should do universal or selective screening.
  • However, there is agreement that screening must be part of a continuum of care. If you use screening in your setting, there must be a comprehensive plan in place for what will happen when a person screens positive.

The Joint Commission's Statements on Screening

  • Regarding Behavioral Health Care:
    “Screen all individuals served for suicidal ideation using a validated screening tool”
  • Regarding hospitals and critical access hospitals:
    “Screen all patients for suicidal ideation who are being evaluated or treated for behavioral health conditions as their primary reason for care using a validated screening tool” (required for age 12 and above). 
    Access the Joint Commission Perspectives >>

Screening Tools

There are several choices for validated screening tools.
Below are some that are commonly used.  top view of Medicine doctor hand working with modern computer and smart phone on wooden desk as medical concept

The Columbia Suicide Severity Rating Scale Screener
  • The screener includes 6 items and is frequently used to screen for suicide risk.
    Access the Screener >>
  • The site includes information about training and numerous versions of the screener and the longer Columbia Suicide Severity Scale for use in varied settings.
    Learn More >>
Item 9 of the PHQ-9 depression scale
  • The PHQ-9 is often used in primary care or other healthcare settings to assess depression severity.
  • Item 9 can be considered a suicide screener. However, the wording is very broad, and a person may agree that they have “thoughts that they would be better off dead” without having any thoughts about actively hurting themselves. A positive response to item 9 may be followed with either the CSSRS-Screener or the ASQ in order to have a better immediate sense of the severity of the suicide risk. 
    Access the PHQ-9 >>
Ask Suicide-Screening Questions (ASQ) Toolkit
  • This page provides links to the ASQ tool, which is a 4-item suicide screener for people aged 8 and older. It can be used in an emergency department, inpatient medical/surgical units, and primary care. 
    Access the Tool >>

If a person screens positive for suicide risk, they should go on to have a comprehensive risk assessment.

For more information about suicide screening and assessment, please visit:

If you are a clinician or community member who needs help to decide what to do about a person who may be at risk for suicide, please call The Providence Center 24-hour Behavioral Health Emergency Line: (401)-274-7111.

Let's Talk: Suicide Prevention For All

Being able to talk about suicide in a straightforward, confident way communicates to our patients and loved ones that it is okay to talk about suicide. We have gathered helpful resources that can help facilitate these conversations. 

Learn More
This information was developed by the Care New England Suicide Prevention Workgroup, which includes membership across Care New England operating units.