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Ask Suicide-Screening Questions (ASQ) Toolkit
Ask Suicide-Screening Questions (ASQ) Toolkit
| Availability |
Please visit this website for more information about the instrument: Ask Suicide-Screening Questions (ASQ) Toolkit
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| Classification |
Supplemental: Mitochondrial Disease (Mito)
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| Short Description of Instrument |
The Ask Suicide-Screening Questions (ASQ) tool is a set of four brief suicide screening questions that takes 20 seconds to administer.
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| Comments/Special Instructions |
This is a brief tool validated for use among both youth and adults. The tool is available as a free resource.
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| Scoring and Psychometric Properties |
Scoring: 4 yes/no questions are asked. "Yes" response to any of the questions prompts additional screening and action steps.
Psychometric Properties: "Yes" response to one or more of the questions in the screener identified 97% of youth at risk for suicide. Subsequent multisite studies have demonstrated validity in adult medical patients as well.
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| Rationale/Justification |
Strengths: This is an open-source measure associated with training and toolkit materials developed for a variety of medical settings. The measure takes only a few seconds to administer. Translations available in 16 languages in addition to English. The Joint Commission has highlighted the need to screen for suicidality as part of routine medical care, and this measure has been highlighted as a low burden and useful tool in doing so. A large number of providers feel satisfied or highly satisfied with the application of this tool (Christensen LeCloux et al., 2022).
Weaknesses: Asking questions about suicidality can be distressing for staff and providers who do not have adequate training. In many settings, behavioral health resources are limited, and accessing adequate care for individuals who screen positive can be challenging. The false positive rate (9%) is higher than some other screening measures, and this can lead to challenges about how to assess for risk and how to adequately assess further for safety (Gardner and Pajer, 2021).
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| References |
Key References:
Horowitz LM, Bridge JA, Teach SJ, Ballard E, Klima J, Rosenstein DL, Wharff EA, Ginnis K, Cannon E, Joshi P, Pao M. Ask Suicide-Screening Questions (ASQ): a brief instrument for the pediatric emergency department. Arch Pediatr Adolesc Med. 2012 Dec;166(12):1170-6.
Horowitz LM, Mournet AM, Sheftall A, He JP, Lowry NJ, Aguinaldo LD, Sullivant SA, Wharff EA, Merikangas KR, Pao M, Bridge JA. Assessing the Validity of the Ask Suicide-Screening Questions in Black Youth. J Acad Consult Liaison Psychiatry. 2023 Jul-Aug;64(4):332-35.
Horowitz LM, Snyder DJ, Boudreaux ED, He JP, Harrington CJ, Cai J, Claassen CA, Salhany JE, Dao T, Chaves JF, Jobes DA, Merikangas KR, Bridge JA, Pao M. Validation of the Ask Suicide-Screening Questions for Adult Medical Inpatients: A Brief Tool for All Ages. Psychosomatics. 2020 Nov-Dec;61(6):713-22.
Additional References:
Christensen LeCloux M, Aguinaldo LD, Lanzillo EC, Horowitz LM. Provider opinions of the acceptability of Ask Suicide-Screening Questions (ASQ) Tool and the ASQ Brief Suicide Safety Assessment (BSSA) for universal suicide risk screening in community healthcare: Potential barriers and necessary elements for future implementation. J Behav Health Serv Res. 2022 Jul;49(3):346-63.
Gardner W, Pajer K. Screening for Suicide Risk in Hospital Admissions: What are the Next Questions? J Adolesc Health. 2021 Jun;68(6):1036-37.
Document last updated March 2024
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