All patients presenting with mental health concerns should be screened for suicide. Many EDs also screen patients presenting for other reasons as well. There are many “screens” and one simple one that is used locally and can be effective in your setting is the ASQ – The Ask Suicide-Screening Questions. It is really straightforward, includes only 5-questions, and should be asked to the patient in confidence if possible. Positive answers should be responded with immediate referral to appropriate mental health services:

In the past few weeks, have you wished you were dead?

In the past few weeks, have you felt that you or your family would be better off if you were dead?

In the past week, have you been having thoughts about killing yourself?

Have you ever tried to kill yourself?

Horowitz et al. noted that this 4-question screen is highly sensitive and specific.