{{ summaryTitle }}
{{ summaryValue }}
{{ summaryLine }}
{{ badge.label }}

Before you begin

Use this NIMH public-domain clinician guide only after a positive youth ASQ screen. It records structured workflow findings and the clinician-selected disposition; it does not calculate suicide risk.

Required context. The setting changes disposition handoff language but never calculates a result.
Privacy: {{ assessmentMemoryDisclosure }} {{ assessmentDefinition.privacy.disclosure }}
This changes only the presentation order of the answer ledger; it never changes the recorded disposition or safety rules.
{{ progressPercent }}%
{{ progressLabel }}
{{ currentQuestion.text }}

Record the clinician's finding after completing this checkpoint. Keep narrative details and identifiers in the authorized clinical record.

Safety and support
  • {{ action.label }}

This shared result is read-only. Start a new session to record different answers.

What this means

{{ interpretationArtifact ? interpretationArtifact.lead : 'No interpretation is available for this result.' }}

What to do next

{{ Array.isArray(interpretationArtifact && interpretationArtifact.points) && interpretationArtifact.points.length ? interpretationArtifact.points[0] : 'Review this result in context and use the stated limits before acting.' }}

  • {{ point }}

{{ interpretationArtifact ? interpretationArtifact.uncertainty : 'This result is informational and should be interpreted within the assessment scope.' }}

Understand your scoreSee the canonical score in its declared range

{{ scorePositionArtifact.summary }}

Loading score-position chart…

{{ assessmentChartStatus }}
Review your answersCheck the responses behind this result
ItemPromptAnswerCopy
{{ row.label }}{{ row.prompt }}{{ row.answer }}

No answer rows are available for this result.

Save or shareOptional handoffs for this completed result
Score chart
Answer review
Ask Suicide-Screening Questions (ASQ) Route a clinician-administered ASQ screen to the NIMH negative, non-acute, or acute pathway with patient-group refusal handling and safety actions.
NIMH Adult Brief Suicide Safety Assessment Document the clinician-led NIMH Adult BSSA after a positive ASQ screen, with immediate safety rules and setting-aware disposition guidance.
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.
Primary Care PTSD Screen (PC-PTSD-5) Check a lifetime trauma gate and five past-month PTSD symptoms, then see how the 0–5 PC-PTSD-5 score compares with 3+ and 4+ cut points.

Youth suicide safety assessment often needs two perspectives. A private, developmentally appropriate interview gives the young person room to speak, while a parent or guardian can add observations, describe support at home, and help secure potentially dangerous items. Neither perspective should be reduced to a number.

The National Institute of Mental Health (NIMH) Youth Brief Suicide Safety Assessment (BSSA) is used after a positive Ask Suicide-Screening Questions (ASQ) screen for patients ages 8 to 24. It guides a trained clinical professional through recent and current thoughts, plans and access to means, past behavior, symptoms, stressors, supports, reasons for living, safeguarding steps, and a clinician-selected disposition.

Patient interview
The clinician gathers enough information to choose a disposition and may stop when that decision can be made safely.
Parent or guardian role
Participation should fit the patient's development and situation. For a patient age 18 or older, permission is obtained before the parent or guardian joins.
Care setting
Emergency department, inpatient medical or surgical care, and outpatient care have different handoff language even though the immediate safety rules remain the same.

Current suicidal thoughts require an urgent or STAT mental-health evaluation, continuous supervision, and the setting's immediate safety protocol. A young person who says help is needed to stay safe also requires immediate action. A no response does not prove safety.

The BSSA records structured findings and clinical judgment. It is not a self-assessment, a diagnosis, an automated suicide-risk score, or permission to discharge or leave someone alone.

How to Use This Tool:

A trained clinical professional should use the checklist only within the youth ASQ pathway after a positive screen.

  1. Choose the Care setting before starting. This selects the appropriate disposition handoff wording but does not calculate a result.
  2. Record findings from the private youth interview, then document the parent or guardian perspective and home-safety concerns when applicable. Keep narrative details and identifiers in the authorized clinical record.
  3. Follow an urgent safety notice as soon as it appears. Current suicidal thoughts or a stated need for help to remain safe take precedence over every general disposition.
    Do not leave the patient alone when current suicidal thoughts are present. Notify the medical team and follow the setting's urgent or STAT pathway.
  4. Complete safety planning, coping, means-restriction, resource, and follow-up checkpoints as the clinical pathway allows. A safety plan is not a promise or contract for safety.
  5. Record the clinician-selected disposition, then compare it with the active safety notice and setting-specific next action before completing the handoff.

Interpreting Results:

Clinician-selected disposition is the primary result. It repeats the category chosen by the trained clinician; the preceding findings do not add up to that category. The displayed level is therefore a record of a decision, not a measurement of suicide risk.

Safety notices answer a different and more immediate question. A positive current-thoughts finding or a request for help staying safe activates an action rule regardless of the selected disposition. Complete that safety response first.

  • Read Not yet determined, Review incomplete, and Not completed literally. None is equivalent to a negative finding.
  • A guardian who is not comfortable keeping the patient safe at home is a safeguarding concern that belongs in clinical judgment and handoff planning.
  • A change in the patient's condition after the checklist requires reassessment; the saved selection does not remain authoritative.

Technical Details:

The youth checklist contains 16 structured entries. One records the care setting, fourteen cover interview and safeguarding checkpoints, and one records the disposition. The documentation codes can highlight safety-relevant findings in the answer review, but they are not summed.

Rule Core

No arithmetic Formula Core applies. The only ordinal output is a one-to-one display code for the clinician's literal disposition choice.

Selected disposition Display level What the level does not mean
No further intervention necessary at this time 0 It does not establish zero risk or cancel an active safety rule.
Non-urgent mental health follow-up 1 It is not produced by a checkpoint total.
Further evaluation of risk is necessary 2 It is the clinician's selected category, not a probability band.
Emergency psychiatric evaluation 3 It is the most urgent selected category, not a calculated cutoff.

The current-thoughts rule has the highest precedence. A Yes response activates the urgent evaluation notice. The needs-help rule follows with an immediate support notice when the patient says help is needed to remain safe. Both operate independently of the 0 to 3 disposition display.

Choosing a care setting changes the final handoff wording for outpatient, emergency-department, or inpatient care. It does not change response coding, safety-rule activation, or the clinician's recorded disposition.

Safety, Scope, and Privacy:

When a young person has current suicidal thoughts, cannot remain safe, or may be in immediate danger, arrange in-person emergency help now under local clinical policy. In the United States, call or text 988 for the Suicide & Crisis Lifeline; use emergency services for immediate danger.

The BSSA is limited to trained clinical use after a positive youth ASQ screen. It cannot replace developmentally appropriate interviewing, safeguarding duties, parent or guardian involvement when appropriate, a complete mental-health evaluation, or the clinical record.

Responses and care setting stay in the current browser tab and are not sent to a service or put in the URL. Starting over or reloading clears the checklist. Copied or downloaded material can still contain sensitive information and must be protected under the care setting's privacy rules.

References: