Screening

Various scales have been investigated for their accuracy in predicting suicide risk, with varying results. Risk scales can provide false reassurance and should no longer be used to predict suicide following self-harm.[134][159] The key message is that suicide cannot be predicted. It is better to focus the assessment of the patient on identifying their risk factors so they can be removed, reduced, or mitigated and focus on helping patients stay safer by producing a safety plan together.[130][160][161][162][163][164]​​

A summary of the evidence for suicide risk screening in adult primary care patients was produced for the US Preventive Services Task Force (USPSTF) in 2013.[165]​ It found there to be insufficient evidence to determine the benefits of screening in primary care populations. Very limited evidence identified no serious harms associated with screening in primary care. Limited evidence suggested that screening tools might enable identification of some adults at increased risk for suicide, although accuracy was lower in studies of older adults.[165]​​ In an updated summary produced in 2022, the USPSTF found there to be insufficient evidence to assess the balance of benefits and harms of primary care screening for suicide risk in children and adolescents.[165]​ In 2022, the American Academy of Pediatrics (AAP) recommended screening for suicide risk in young people aged ≥12 years as part of its preventive care periodicity schedule.[166]​ To guide this, the AAP and the American Foundation for Suicide Prevention created the 2022 Blueprint for youth suicide prevention.[167]

It is important to differentiate population-based screening from clinical identification and risk assessment of individual patients through the use of 'screening' questions that ask about suicidal ideation. Training primary care providers to do this in patients with symptoms of depression does not increase frequency of suicidal ideation, and is related to decreased suicide rates.[94][95]

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