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Screening Tools for Suicide Prevention

Suicide prevention programs may also have a clinical component with regard to how patients are screened and treated for mental health disorders or suicidal ideation in healthcare settings. The Patient Health Questionnaire, or PHQ-9, is the most widely used screening tool for depression and suicidal ideation. Many other screening tools also exist; however, some are specific to particular populations or settings.

While rural primary care providers may be familiar with screening tools, they may not always have adequate training, capacity, or resources to implement the screening and respond to the results. However, it is relatively common for individuals to be in contact with their primary care provider in the weeks leading up to a suicide, which makes it especially important for providers to be well-trained in spotting suicidal ideation. Yet, providers may be reluctant to use screening tools if there is confusion about how to document the screening or bill for it. Thus, efforts centered on offering educational tools and resources for providers to refer to may increase the use of depression screenings in primary care. It is also important to involve rural mental health providers in these services when available and appropriate. Integrated care settings, which combine mental health and primary care under one roof, are one useful avenue for doing so.

Community health workers (CHWs) can also play an integral part in screening for depression and suicidal ideation. By participating in mental health training, they can assist with screening and assessment, follow up with patients who are discharged after a suicide attempt, and act as a bridge between hospitals, communities, law enforcement, and schools. With CHWs or other community gatekeepers, screening can also reach beyond the clinical setting to meet individuals within their communities.

As with any screening tool, it is essential that providers and CHWs not only know how to use a suicide screening tool, but also how to follow up if a patient is at risk of attempting suicide.

Program Clearinghouse Examples

Resources to Learn More

The Patient Health Questionnaire (PHQ-9)
Describes the capability of the PHQ-9 screening tool, and how to use it for diagnosing depression, and for treatment selection and monitoring.
Organization(s): Center for Quality Assessment and Improvement in Mental Health (CQAIMH)
Date: 1999

SAFE-T Pocket Card: Suicide Assessment Five-Step Evaluation and Triage for Clinicians
Gives a five-step process for clinicians for conducting and triaging a suicide assessment.
Organization(s): Substance Abuse and Mental Health Services Administration
Date: 2009

Suicide Prevention Toolkit for Primary Care Practices
Provides information, tools, and resources to help primary care providers implement suicide prevention practices, develop a risk assessment methodology, and explore a variety of patient management interventions appropriate for a primary care setting.
Organization(s): Suicide Prevention Resource Center (SPRC), Western Interstate Commission for Higher Education Mental Health Program (WICHE)