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.[131][132] 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.[135][136]​​​[137]​​[138][139][140]​​

An updated summary of the evidence for suicide risk screening in asymptomatic adult care patients was produced for the US Preventive Services Task Force (USPSTF) in 2023.[135]​ It found that screening for depression in adults has moderate net benefit; however, there was insufficient evidence to determine the benefits and harms of screening for suicide risk in adult populations. Evidence on harms of screening for suicide risk is limited, and studies of suicide prevention interventions showed they were no more effective than standard care.[135]​ One 2022 systematic review by the USPSTF found insufficient evidence to evaluate the balance of benefits and harms of screening for suicide risk in children and adolescents.[141]​ In February 2022, Bright Futures and the American Academy of Pediatrics (AAP) recommended screening for suicide risk in young people ages ≥12 years as part of its preventive care periodicity schedule.[136]​ To guide screening for and assessment of suicide risk in healthcare settings, the AAP and the American Foundation for Suicide Prevention created the 2022 Blueprint for Youth Suicide Prevention.[142]​ In 2024, the AAP recommended screening for suicide risk as part of well-child visits starting at 12 years old, and during higher-risk situations, such as any presentation of a behavioral or mental health concern or for youth with additional risk factors.[126]​ Adolescents should also be screened for suicide risk during ED visits and medical hospitalizations.[126]​

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.[96][97]

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