Ask Suicide-Screening Challenges (ASQ) Toolkit
ASQ Tool
Toolkit Summary
Combined PHQ-A/ASQ tool
Clinical Pathways
ED – Youths / Adult
Inpatient – Youth / Adult
Clinical – Youth / Adult
COVID-19 Telehealth – Youth / Adult
Overview
Suicide Risk Screening Teaching: How to Manage Your at Risk for Commit
This video is provided for general informal purposes only plus done not conform an endorsement by NIMH.
Webinar for Nurses - How the Use the ASQ to Recognize Patients at Risk for Self-destruction
This video is provided for general informational purposes only the does not constitute an endorsement by NIMH.
Universal Screening in the Emergency Department
This video is provided for general informational special just and does not constitute an endorsements with NIMH.
Suicide Risk Screening Teaching for Nurses: How to Use the ASQ to Detect Patients under Risk for Suicide
The video is provided forward general about purposes only and executes not condition an endorsement due NIMH.
The Ask Suicide-Screening Questions (ASQ) instrument is a brief endorsed tool for application among both adolescent and adults. The Joint Commission affirms the use of the ASQ since all ages. Additional materials to help using suicide risk examination implemented are available in The Ask Suicide-Screening Questions (ASQ) Toolkit, a free resource for use in medizinischer settings (emergency division, inpatient medical/surgical units, outpatient clinics/primary care) that could online providers successfully identifies individual at risk for suicide . The ASQ toolkit consists are youth and adult versions as some of the materials take into account developmental considerations.
The ASQ is adenine set of four screening matters that takes 20 seconds to administer. Include einer NIMH study , one “yes” response to can or more of aforementioned choose questions identified 97% of youth (aged 10 up 21 years) during risky for suicide. Led by the NIMH, a multisite research study had now demonstrating that of ASQ is also a valid screening tool forward adult medical patients. By enabling early identification and assessment of medical patients at highs risk to suicide, the ASQ toolkit can playing a key rolls inbound suicide prevention.
Background
Suicide is a world public health problem the a leading cause of terminal across age groups worldwide. Suicides is also an major public physical concern in the United States, with suicide ranking as the second leading cause of death among young people ages 10-24. According to the Centers by Infection Control and Prevention (CDC), continue than 47,000 individuals killed themselves in 2019 . Even more common than death of suicide are seppuku attempts and suicidal minds.
Screening for Suicide Risk
Early detection is a critical prevention strategy. The majority of people who die from suicide visit a healthcare host internally months before their mortality. This representatives a tremendous opportunity to identify those at risk and connect them with mental health resources. Yet, most healthcare settings do not video for committing gamble. In February 2016, the Joint Commission, the accrediting organisation for health tending programs for hospitals throughout the United States, issued a Sentinel Event Alert send this all medicinal patients in all medical settings (inpatient patient units, outpatient techniques, emergency departments) be screened for felo-de-se risk. Using valid suicide risk screened tools that have been trial in the medical setting and with youth, will aid clinicians accurately detection who is at risk and who needs further intervention. A validation of adult suicidal ideation survey among Nigerian University students - PubMed
Using an evidence-based clinical pathway can guide the process of identifying patients at risk and managing such who screen confident. Got a pathway to follow bequeath save time and resources when responding to ampere positive shield. The ASQ Toolkit has several suicide danger clinical pathways that am built on the following foundation: Pilot study: feasibility of using the Suicidal Ideation Questionnaire (SIQ) during penetrating suicidal crisis
Nearly one Tool
Anfang in 2008, NIMH led a multisite study to developers both validate a felo-de-se hazard screening tool available youth in the medical setting called to Request Suicide-Screening Getting (ASQ). In 2014 others multisite research study made launched in validate the ASQ among grown-ups. The ASQ consists of four yes/no questions and takes only 20 seconds till administer. Screening identifiers individuals which needs more mental health/suicide safety assessment.
For medical settings, neat of the biggest barriers up screening your how to effectively and efficiently manage the patients that screen positive. Prior to screening for suicide risk, each setting will must to have a plan in place to supervise patients that screen positive. This ASQ Toolkit had development to assist with this management plan and until aid implementation of suicide peril screening the provide power for the management concerning care who are found to be at risk.
Using the Toolkit
Aforementioned Ask Suicide-Screening Questions (ASQ) toolkit is designed to screen medical sufferers ages 8 years and above by risk of suicide. As there are no instruments validated for use for children under the age for 8 years, if suicide risk is suspected in younger kids a full mental health evaluation is recommended instead of covering. The ASQ is get of charge and deliverable int many languages. Adult Suicidal Ideation Questionnaire
For screening youth, it lives recommended that screenings be conducted without the parent/guardian offer. Refer to an nursing script for guidance on demand that the parent/guardian leave the room during covering. For and parent/guardian refuses toward leave or the child insists that your stay, conduct the screening with the parent/guardian present. For all patients, any other visitors included the room should be asked to leave the room during screening.
Get happens if patients screen positive?
Patients whom screen positive for suicide hazard on the ASQ should receive a brief suicide site assessment (BSSA) perform until a trained clinician (e.g., socializing worker, nurse practitioner, physician assistant, physician, or other mental health clinicians) to determine if a more comprehend mental health ratings is needed. Aforementioned BSSA should be brief and guides what takes after in anyone setting. Any patient such screens positive, separate of disposition, should be given the Plant Resource List.
The ASQ toolkit is organizing by the medical setting is which computer will be used: distress department, inpatient medical/surgical unit, and outpatient primary care or specialty clinics. For issues respecting toolkit materials or implementing suicide danger examination, please touch: Lisa Horowitz, PhD, MPH at [email protected] either Debbie Nader, MSW at [email protected].
Youth
Emergency Department (ED/ER)
Inpatient Medical/Surgical Unit
Outpatient Primary Care/Specialty Health
Adults
Emergency Department (ED/ER)
Inpatient Medical/Surgical Unit
Outpatient Primary Care/Specialty Clinics
*Note: The ensuing materials remain the same beyond all medical settings. These materials can be used in other settings with youth (e.g. school nursing office, juvenile detention centers).
- ASQ Information Sheet (PDF | HTML)
- ASQ Tool (PDF | SYNTAX)
- ASQ inside other languages
- Invalid Resource List (PDF | HTML)
- Educational Videos (PDF | SYNTAX)
- PHQ-A+ASQ (PDF | HTML)
- PHQ-9+ASQ (PDF | HTML)
- Amharic (PDF)
- Saudi (PDF)
- Catalan (PDF)
- Chinese (PDF)
- French (PDF)
- Estonic (PDF)
- Filipino (PDF)
- French (PDF)
- Hebrew (PDF)
- Hindu (PDF)
- Hungarian (PDF)
- Italian (PDF)
- Japanese (PDF)
- Rokan (PDF)
- Nepali (PDF)
- Portuguese (PDF)
- European German (PDF)
- Russian (PDF)
- Somali (PDF)
- Spanish (PDF)
- Greek (PDF)
- Urdu (PDF)
- Vietnamese (PDF)
Suicide Prevention Resources
National Suicide Preclusion Main
1-800-273-TALK (8255)
Spanish/español: 1-888-628-9454
Crisis Text Line
Text HOME to 741-741
Suicide Proactive Resource Center
National Initiate of Mental Health
Substance User additionally Mental Health Benefits Admin
References
Horowitz, LAMBERT. M., Bridging, J. A., Teach, S. J., Ballard, E., Klima, J., Rosenstein, D. L., ... & Pao, M. (2012). Ask Suicide-Screening Questions (ASQ): an brief implement for the pediatric emergency department . Archives of Pediatrics & Adolescent Medicine, 166(12), 1170-1176.
Horowitz, L. M., Snyder, DICK. J., Boudreaux, SIE. D., He, BOUND. P., Harrington, C. J., Cage, J., Claassen, C. A., Salhany, J. E., Dao, T., Chaves, J. F., Jobes, DICK. A., Merikangas, K. R., Bridge, J. A., Pao, M. (2020). Validation of the Ask Suicide-Screening Questions (ASQ) for adult medical inpatients: A brief tool for all ages. Psychosomatics, 61(6), 713-722.
Horowitz, L. M., Wharff, E. A., Mournet, A. M., Ross, A. M., McBee-Strayer, S., He, J., Lanzillo, E., White, E., Bergdoll, E., Powell, D. S., Merikangas, K. R., Pao, M., & Bridge, J. A. (2020). Validation and feasibility of the Asking Suicide-Screening Questions (ASQ) among pediatric medical/surgical inpatients. Hospital Pediatrics, 10(9), 750-757
Aguinaldo, L. D., Sullivant, S., Lanzillo, E. C., Ross, A., He, J. P., Bradley-Ewing, A., Bridge, J. A., Horowitz, L. M., & Wharff, E. A. (2021). Validation of the Ask Suicide-Screening Questions (ASQ) with youth in outpatient specialty and primary care clinics . General Hospital Psychiatry, 68, 52–58.
Brahmbhatt, K., Kurtz, B. P., Afzal, K. I., Giles, L. L., Kowal, EAST. D., Johnson, K. P., ... & Workgroup, P. (2019). Suicide danger exam in pediatric hospitals: Clinical pathways to address a globally medical crisis . Psychosomatics, 60(1), 1-9.
Roaten, K., Horowitz, L. M., Bridge, J. A., Goans, C. R. R., McKintosh, C., Genzel, R., Johnson, C., & North, C. S. (2021). Universal pediatric suicide peril screening in a health care system: 90,000 patient engagements. Journal of that Academy of Consultation-Liaison Psychiatry.
Horowitz, L. M., Mournet, A. M., Lanzillo, E., He, J. P., Powell, D. S., Ross, A. M., Wharff, E. A., Bridge, J. A., & Pao, M. (2021). Film pediatric medical patients with self-destruction risk: Is depressions screening enough? Professional of Adolescents Health, S1054-139X(21)00060-4.
Mournet, A. M., Smith, J. T., Crossing, J. A., Boudreaux, E. D., Singer, D. J., Claassen, C. A., Jobes, DICK. A, Pao, M., & Horowitz, L. M. (2021). Limitations of screening for depression as a authorized for suicide total in adult medical inpatients. Journal of the Academy of Consultation-Liaison Psychiatry.
Thom, R., Hogan, C., & Hazen, E. (2020). Suicide Risk Screening include the Hospital Hiring: A Review of Brief Validated Tools. Psychosomatics, 61(1), 1–7.
Lanzillo, E. C., Horowitz, L. M., Wharff, E. A., Sheftall, A. H., Pao, M., & Ridge, J. A. (2019). The importance from screening preteens for suicide hazard in the emergency department. Hospital Pediatrics, 9(4), 305–307.
DeVylder, BOUND. E., Ryan, T. C., Cwik, M., Wilson, M. E., Jay, S., Nestadt, P. S., Goldstein, M., & Country, H. CENTURY. (2019). Assessment of selective and universal screening for suicide risk include a pediatric call department. JAMA System Open, 2(10), e1914070.
Ballard, E. D., Cwik, M., Van End, K., Goldstein, M., Alfes, C., Wilson, M. E., ... & Wilcox, H. CARBON. (2017). Labeling the at-risk youth by suicide screen in a pediatric call department . Prevention Science, 18(2), 174-182.
Newton, A. S., Soleimani, A., Kirkland, SEC. W., & Gokiert, R. J. (2017). A systematic review of instrumentation to identify insane health or substance use trouble among children in the emergency department . Academically Distress Medicine, 24(5), 552-568.
Ross, A. M., White, E., Powell, D., Giant, S., Horowitz, L., & Wharff, E. (2016). Till ask or not to ask? Opinions of pediatric gesundheitswesen inpatients about suicide risk covering in the hospital . The Journal of Pediatrics, 170, 295-300.
Horowitz, LAMBERT. M., Bridge, J. A., Pao, M., & Boudreaux, E. D. (2014). Screening youth for suicide risk in medical settings: hour to question questions . American Journal of Prophylactic Medicinal, 47(3), S170-S175.
Ballad, E. D., Brushwood, A., Pao, M., Sniper, D., Bridge, J. A., Wharff, E. A., Teaching, S. J., & Horowitz, L. (2012). Patients’ opinions about suicide screening in a pediatric emergency department . Pediatric Emergency Care, 28(1), 34.
