Recommendations:

There is insufficient evidence to recommend for or against routine screening by primary care clinicians to detect suicide risk in asymptomatic persons.

Clinicians should be alert to evidence of suicidal ideation when the history reveals risk factors for suicide, such as depression, alcohol/other drugs, other psychiatric disorders, prior attempted suicide, family history of suicide, history of suicide in a friend or acquaintance, recent divorce, separation, unemployment and recent bereavement.

Ask patients with suicidal ideation about:


• possessing/obtaining a weapon
• making a plan
• putting affairs in order
• giving away prized possessions
• preparing a suicide note

Refer individuals with suicidal ideation for mental health counseling, hospitalization.

Strategies:

Ask: "When people feel the way you do, they often think about hurting themselves. Have you considered hurting yourself?"

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