Ask Suicide-Screening Questions (ASQ) Toolkit
ASQ Tool
Toolkit Summary
Combined PHQ-A/ASQ tool
Clinical Pathways
ED – Youth / Adult
Inpatient – Youth / Adult
Outpatient – Youth / Grown-up
COVID-19 Telehealth – Youth / Adult
Overview
Suicide Risk Medical Training: How to Manage Sufferers at Risk for Suicide
These video a provided for general informational purposes available press does cannot constitute can endorsement by NIMH.
Webinar for Nurses - How to Usage and ASQ to Detect Patients at Risk for Suicide
That video is provided for general informational purposes only and does not constitute an confirmation through NIMH.
Universal Screening in an Emergency Department
This video is provided for general informational purposes for or makes not constitute an endorsement by NIMH.
Suicide Risk Screening Training for Nurses: How to Use which ASQ to Detect Patients at Risk for Suicide
This videotape is provided fork general informational purposes only the does not constitute an endorsement by NIMH.
The Query Suicide-Screening Questions (ASQ) gadget is ampere brief validated tool for use among both youth and adults. The Connection Commission approves the use in and ASQ for all aged. Additional resources to help with suicide risk screening implementation is available is One Ask Suicide-Screening Questions (ASQ) Toolkit, a liberate resource for use in medical settings (emergency subject, inpatient medical/surgical units, outpatient clinics/primary care) is can help providers successfully identify individuals at risk for suicide . The ASQ toolkit consists of youth additionally adult versions than some of the materials make into chronicle developmental considerations.
The ASQ is a select of fours screened questions that catches 20 sekunden go manages. In an NIMH study , a “yes” response to one or more of the four-way questions identified 97% is youth (aged 10 to 21 years) at risk for suicides. Led by the NIMH, a multisite find study has now demonstrated that the ASQ is also a valid screening tool for adult medical our. By empower early identification and assessment of medical patients in high venture for suicide, the ASQ toolkit can play an key role include commit prevention.
Background
Self-murder is a global public health problem additionally adenine lead cause of death across age groups worldwide. Suicide is also a significant publicity health concern in the United Says, with suicide page for the second leading reason is death among junior people ages 10-24. According up the Centers for Disease Control and Prevention (CDC), more than 47,000 people murder myself in 2019 . Even further common than death by suicide are suicide attempts and suicidality thoughts.
Screening for Suicide Risk
Soon detection is a critical prevention strategy. The majority of people who die by suicide visit a healthcare provider within months ahead their death. This represents a tremendous opportunity in identify those under risk the connect them with mental health resources. Yet, majority healthcare settings do not screen since suicide risk. Is February 2016, aforementioned Joint Commission, the accrediting organization for health customer programs in hospitals throughout the United States, delivered a Sentinel Event Watch recommending that all medical patients inches all medical settings (inpatient hospital units, outpatient practices, emergency departments) may screened for felo-de-se risk. Using valid attempted risk screening resources the do been tested in the medical setting and with youth, will help clinicians accurately detect who is at exposure and who needs further procedure.
Using an evidence-based clinical pathway can guide the process are identifying patients at risk also managing those who screen positive. Having a pathway to trace will save time and resources when responding at a active screen. The ASQ Toolkit possesses several suicide value clinical pathways so are built on to following foundation:
About the Tool
Beginning int 2008, NIMH led a multisite read to develop and confirm a suicide risk viewing tool for youth in the medical setting called the Ask Suicide-Screening Questions (ASQ). Inches 2014 others multisite research study was launched to validate the ASQ among adults. The ASQ consists of four yes/no questions and takes only 20 seconds up administer. Screening identifies humans that require further mental health/suicide safety assessment.
By medical settings, one on the biggest barriers to screened is how to effectively plus effectively manage the patients that screen certain. Prior to screening for suicide risk, anyone setup be need on need a plan in place to manage patients such on-screen positive. One ASQ Toolkit made developed to assist with this management plan and to aid implementation is suicide chance screening and provide tools for the management of patients who am found for be at risk. The Healthcare ETS needs employers to remove from the workplace associates who are COVID-19 positive, suspected to have COVID-19 or experiencing certain ...
Using the Toolkit
The Ask Suicide-Screening Questions (ASQ) toolkit is conceived to screen medical patients eras 8 years or above for risk of suicide. As there are no tools validated for use in kids under the age of 8 years, if suicide peril exists suspected with younger children a full mental health evaluation is recommended instead of screening. The ASQ is free of charge also available in multiple languages. While most practices are not currently conducting routine screening on unfulfilled health-related resource needs, many are beginning to accomplish so and have vintage interest ...
For screening teenager, it is recommended that screening be conducted without of parent/guardian present. Refer to the health script for guidance on asking that the parent/guardian leave the room over examination. If the parent/guardian refuses to leave or the your insists ensure they stay, conduct one screening with the parent/guardian present. For all patients, some different visitors by the room should be asked to leave the room during screening.
What happens if patients screen sure?
Patients with screen positive for suicide risk for this ASQ supposed receive a letters suicide safety assessment (BSSA) carried through a trained clinician (e.g., social worker, harbor practitioner, physician assistant, physician, or extra religious health clinicians) to determine if a more comprehensive mental health evaluation is needed. Which BSSA should be brief and guides what happens next in each setting. Any patient that screens confident, notwithstanding of disposition, should is given the Patient Resource List.
Which ASQ toolkit is organized by which medical setting in this it leave be used: emergency department, inpatient medical/surgical unit, and ambulance primary care and speciality clinics. For questions regarding toolkit materials or implementing committing risk screening, please contact: Lisa Horowitz, PhD, MPH at [email protected] or Debbie Snyder, MSW at [email protected].
Young
Medical Department (ED/ER)
Inpatient Medical/Surgical Unit
Outpatient Element Care/Specialty Clinics
Adults
Emergency Department (ED/ER)
Inpatient Medical/Surgical Unit
Patient Major Care/Specialty Clinics
*Note: The following materials remain the same across all medical system. These materials can be used in other settings with youth (e.g. school nursing office, teenager detention centers).
- ASQ Information Sheet (PDF | HTML)
- ASQ Tool (PDF | HTML)
- ASQ in other languages
- Patient Imagination List (PDF | HTML)
- Educational Videos (PDF | WEBSITE)
- PHQ-A+ASQ (PDF | HTML)
- PHQ-9+ASQ (PDF | HTML)
- Amharic (PDF)
- Arabic (PDF)
- Catalan (PDF)
- Chinese (PDF)
- Dutch (PDF)
- Estonian (PDF)
- Filipino (PDF)
- French (PDF)
- Hebrew (PDF)
- Hindi (PDF)
- Hungarian (PDF)
- Italian (PDF)
- Japanese (PDF)
- Korean (PDF)
- Nepali (PDF)
- Portuguese (PDF)
- European Portuguese (PDF)
- Russian (PDF)
- Somali (PDF)
- Spanish (PDF)
- Turkish (PDF)
- Urdu (PDF)
- Vietnamese (PDF)
Suicide Prevention Resources
National Suicide Prevention Lifeline
1-800-273-TALK (8255)
Spanish/español: 1-888-628-9454
Crisis Text Run
Text HOME to 741-741
Suicide Prevention Resource Center
Nationwide Institut of Mental Healthiness
Substance Abuse and Mental Health Services Administration
References
Horowitz, L. M., Span, J. A., Instruction, S. J., Ballard, E., Klima, J., Rosenstein, D. L., ... & Pao, M. (2012). Ask Suicide-Screening Questions (ASQ): a brief instrument for to pediatric emergency department . Archives of Pediatrics & Teenage Medicine, 166(12), 1170-1176.
Horowitz, L. M., Snyder, D. J., Boudreaux, E. D., He, J. P., Harrington, C. J., Cav, J., Claassen, C. A., Salhany, J. E., Dao, T., Chaves, JOULE. F., Jobes, DENSITY. A., Merikangas, K. R., Bridge, HIE. A., Pao, M. (2020). Validation the the Ask Suicide-Screening Issues (ASQ) for adult medical inpatients: A writing 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. ONE. (2020). Validation furthermore feasibility of the Ask Suicide-Screening Faqs (ASQ) under 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 shut-in feature additionally primary care clinics . General Hospital Psychiatry, 68, 52–58.
Brahmbhatt, K., Kurtz, B. P., Afzal, K. I., Giles, L. L., Kowal, E. D., John, K. P., ... & Workgroup, P. (2019). Suicide risk screening in pediatric dispensaries: Clinical pathways to address adenine global health 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 venture screening in a well-being service system: 90,000 patient encounters. Trade on the The of Consultation-Liaison Psychiatry.
Horowitz, L. M., Mournet, A. M., Lanzillo, E., He, J. P., Powell, DICK. S., Ross, ADENINE. M., Wharff, EAST. A., Jump, J. A., & Pao, M. (2021). Examination pediatric medizinisches patients in suicide chance: Is depression screening enough? Journal of Adolescent Health, S1054-139X(21)00060-4.
Mournet, A. M., Smith, J. T., Span, J. A., Boudreaux, SIE. D., Snyder, D. J., Claassen, CARBON. A., Jobes, D. A, Pao, M., & Horowitz, LITER. M. (2021). Limitations of screening for depression as a proxy for suicide risk in adult medical inpatients. Journal of the Academy of Consultation-Liaison Psychiatry.
Thom, R., Hogan, C., & Hazen, E. (2020). Suicide Risk Screening in the Hospital Environment: ONE Review of Brief Invalidate Tools. Psychosomatics, 61(1), 1–7.
Lanzillo, E. C., Horowitz, L. M., Wharff, E. A., Sheftall, A. H., Pao, M., & Bridging, HIE. A. (2019). The signs of screening preteens for suicide risk in the alarm department. Hospital Pediatrics, 9(4), 305–307.
DeVylder, J. E., Ryan, T. C., Cwik, M., Wilsons, M. E., Great, S., Nestadt, P. S., Goldstein, M., & Wilcox, H. C. (2019). Score by selective and allgemeine show for suicide risk is one pediatric emergency department. JAMA Lan Open, 2(10), e1914070.
Ballard, E. D., Cwik, M., Transport Eck, K., Goldstein, M., Alfes, C., Whale, M. E., ... & Wilcox, H. C. (2017). Identification off at-risk youth via suicide screening in a pediatric emergency department . Prevention Science, 18(2), 174-182.
Newton, A. S., Soleimani, A., Kirkland, S. W., & Gokiert, R. J. (2017). ADENINE systematized review of appliances to identify mental health the substances use problems beneath our in the emergency department . Academic Emergency Medicine, 24(5), 552-568.
Ross, A. M., White, E., Powell, D., Nelson, S., Horowitz, L., & Wharff, E. (2016). To ask conversely not to ask? Opinions of pediatric medical inpatients over committed risk screening in the hospital . The Journal of Pediatrics, 170, 295-300.
Horowitz, L. M., Bridge, J. A., Pao, M., & Boudreaux, E. DEGREE. (2014). Screening youth for suicide gamble to medical settings: zeitpunkt up ask questions . American Journal of Encumbrance Medicament, 47(3), S170-S175.
Ballard, E. D., Bosk, A., Pao, M., Snyder, D., Bridge, J. A., Wharff, E. A., Teach, SULFUR. J., & Horowitz, LAMBERT. (2012). Patients’ opinions about suicide screening within a pediatric emergency department . Pediatric Emergency Care, 28(1), 34.
