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Before you begin

Use this public-domain NIMH screen only in a prepared medical workflow. Ask the questions verbatim, preserve privacy, and have the positive-screen safety pathway ready.

For youth, refusal is non-acute positive. For adults, refusal alone is documented but is not a positive screen unless another safety concern exists.
Clinical preparation: If question 5 is Yes, the patient cannot leave until evaluated for safety. Keep the patient in sight, remove dangerous objects if possible, and alert the responsible clinician.
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Do not enter attempt method or patient-identifying details in this browser tool.
This changes only the presentation order of the answer ledger; it never changes the clinical route.
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Answer review
Patient Health Questionnaire (PHQ-9) Assessment Score the nine PHQ-9 symptoms, keep functional impact separate, and flag any Item 9 response for direct follow-up regardless of the total.
Geriatric Depression Scale (GDS-15) Assessment Screen past-week depression-related responses in older adults with GDS-15, strict follow-up thresholds, and separate safety cues.
Kessler Psychological Distress Scale (K10) Assessment Measure distress frequency over the past four weeks with K10, compare two published band guides, and review the complete response pattern.
Edinburgh Postnatal Depression Scale (EPDS) Assessment Screen perinatal distress over the past seven days with the 10-item EPDS, clear follow-up ranges, and priority guidance for Question 10.

Suicide-risk screening is a brief entry point into a prepared clinical safety process. It is meant to identify medical patients who need more assessment, not to diagnose a condition or estimate a person's probability of suicide.

The Ask Suicide-Screening Questions (ASQ) begins with four direct questions about recent wishes for death, recent thoughts of being better off dead, thoughts of suicide in the past week, and any lifetime suicide attempt. A positive initial response leads to a fifth question about suicidal thoughts right now. That final answer determines whether the positive screen follows a non-acute or acute pathway.

  • Use the ASQ with verbal, medically stable patients age 8 years and above in a medical setting.
  • Have a trained clinician and the setting's response pathway ready before asking the first question.
  • Ask the questions privately when possible and keep the wording direct.
  • Record identifying details, attempt method, and dates only in the approved clinical record, never in a general browser form.

A negative screen does not override clinical judgment, observed danger, or other safety concerns. A positive screen requires follow-up within the NIMH clinical pathway. An acute positive screen requires urgent safety evaluation and continued observation until the patient is evaluated.

This assessment is for trained clinicians, not unattended self-screening or unsupervised crisis triage. If someone may be in immediate danger, contact local emergency services. In the United States, call or text 988 for the Suicide & Crisis Lifeline.

How to Use This Tool:

Prepare the clinical response pathway first. The patient-group selection changes refusal handling, and the attempt-timing choice applies only when question 4 is answered Yes.

  1. Choose Youth or young adult or Adult under Patient group, then select Start assessment.
  2. Ask questions 1 through 4 exactly and record Yes, No, or the available refusal response. For question 4, record whether the most recent attempt was within the last 12 months, over one year ago, or not documented.
  3. Ask question 5 only when the initial answers activate the positive-screen gate. A negative initial screen marks question 5 as not asked.
  4. Follow the displayed clinical route immediately. Do not delay an acute action while reviewing charts or answer details.
Acute positive screen: arrange a STAT or urgent safety or full mental-health evaluation. The patient cannot leave until evaluated for safety. Keep the patient in sight, remove dangerous objects when possible, and alert the responsible clinician.

Interpreting Results:

The result is a clinical route, not a numeric risk score. Negative screen means none of questions 1 through 4 activated the positive gate. Non-acute positive screen means potential risk was identified and a brief suicide safety assessment is required. Acute positive screen means current suicidal thoughts were reported and the urgent pathway applies.

In this implementation, youth refusal on an initial item activates the non-acute positive route. Adult refusal alone is documented but does not create a positive screen unless another safety concern is present. Clinical judgment can always override a negative route.

Technical Details:

The NIMH ASQ uses ordered clinical decision rules rather than a symptom total or probability model. The first four questions form a positive-screen gate; the fifth question tests current acuity only after that gate opens.

Rule Core

Response patternRouteRequired action
No positive initial responseNegative screenQuestion 5 is not asked; continue routine care unless clinical judgment indicates concern.
Positive initial response and No to question 5Non-acute positive screenComplete the NIMH brief suicide safety assessment and alert the responsible clinician.
Positive initial response and Yes to question 5Acute positive screenBegin the urgent safety pathway and obtain a STAT or full mental-health evaluation.

Question 4 remains positive whether the most recent attempt occurred within the last 12 months, over one year ago, or the timing is not documented. Timing adds clinical context but does not cancel the positive gate.

All answers are required for the applicable route. The route labels are ordinal workflow categories only; differences between them must not be treated as equal numeric intervals or converted into a probability.

Clinical Safety and Privacy:

Responses remain in the current browser tab and sharing is disabled. Do not enter a patient name, contact information, attempt method, or other identifying details. Use the approved clinical record and local protocol for documentation, handoff, observation, environmental precautions, and disposition.

Every positive screen needs the appropriate NIMH follow-up. Provide patient resources regardless of disposition, and never use this browser result as a substitute for a trained clinician's safety assessment.

References: