Behavioral Health Issues — Ask Suicide-Screening Questions (ASQ) — Clinical Pathway: Emergency

Behavioral Health Issues Clinical Pathway — Emergency Department

Behavioral Health Assessment and ASQ Screening

Ask Suicide Screening Questionnaire, ASQ

  • Validated suicide screening for children ≥ 8 years at triage with a behavioral health chief complaint
  • Exclusions: Altered mental status, severe developmental delay
  • Questions may be completed in the presence of parents/guardians
  • If child refuses or cannot answer (e.g., neurologic impairment), document the reason for incomplete screen

Questions

  1. In the past few weeks, have you wished you were dead?
  2. In the past few weeks, have you felt that you or your family would be better off if you were dead?
  3. In the past week, have you been having thoughts of killing yourself?
  4. Have you ever tried to kill yourself?
  5. Are you having thoughts of killing yourself right now?

Helpful Language

Introducing the ASQ
  • Your mental health is just as important as your physical health.
  • I am now going to ask you about your mental health.
If Child Screens Positive and is Alone
  • I’m so glad you spoke up about this. I’m going to talk to your parent/guardian and your medical team.
  • Someone who is trained to talk with kids about suicide is going to come to speak with you.
If Child Screens Positive, Say to Parent/Guardian
  • We have some concerns about your child’s safety that we would like to further evaluate. It’s really important that he/she spoke up about this.
  • I’m going to talk to your medical team, and someone who is trained to talk with kids about suicide is going to come to speak with you and your child.

Reference

NIMH Ask Suicide Questions (ASQ) Toolkit