Clinical pathway for suicide risk screening in adult primary care settings: Special recommendations
Open accessAbstract
Suicide is a serious public health concern. On average, 80% of suicide decedents had contact with primary care within one year of their suicide. This and other research underscore the importance of screening for suicide risk within primary care settings, and implementation of suicide risk screening is already underway in many practices. However, while primary care practices may be familiar with screening for other mental health concerns (e.g., depression), many feel uncomfortable or unprepared for suicide risk screening. To meet the increasing demand for evidence-based suicide-risk screening guidance, we provide a clinical pathway for adult primary care practices (to include family medicine, internal medicine, women's health). The pathway was developed by experts with research, clinical expertise and experience in suicide risk screening and primary care. We also provide detailed guidance to aid primary care practices in their decisions about how to implement the clinical pathway.
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The outpatient clinical pathway for screening was developed by the AACAP PaCC workgroup to assist hospitals, EDs, and inpatient units implementing suicide risk screening, with subsequent versions for outpatient primary and specialty care modified by NIMH.
“The outpatient clinical pathway was developed by the Pathways in Clinical Care (PaCC) workgroup from within the Physically 111 Child committee of the AACAP to assist hospitals and EDS, and inpatient medical/surgical units implementing suicide risk screening to pediatric patients,98 with subsequent versions developed for outpatient primary and specialty care modified by NIMH.99”
From Evidence-based youth suicide prevention and intervention in pediatric primary care settings. (2024) · cites this paper as [99]
The NIMH pathway generally uses a three-step approach to suicide risk screening: brief screening, brief suicide safety assessment, and determining disposition and course of action.
“The NIMH pathway generally uses a three-step approach to suicide risk screening (see Figure 2).: 1) step 1 Brief screening for suicide risk; 2) Step 2: brief suicide safety assessment; and step 3: determining disposition and course of action for patients deemed to be at imminent risk, in need of further evaluation or low risk for suicide.99”
From Evidence-based youth suicide prevention and intervention in pediatric primary care settings. (2024) · cites this paper as [99]
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- Authors
- Ayer, L., Horowitz, L. M., Colpe, L., Lowry, N. J., Ryan, P. C., Boudreaux, E., Little, V., Erban, S., Ramirez-Estrada, S., & Schoenbaum, M.
- Affiliations
- RAND Corporation (US)
- National Institute of Mental Health (US)
- University of Massachusetts Chan Medical School (US)
- Corresponding author
- Ayer, Lynsay
- ORCID
- Venue
- Journal of the Academy of Consultation-Liaison Psychiatry
- Publisher
- Elsevier BV
- Published
- 2022-09
- Volume
- 63
- Issue
- 5
- Pages
- 497-510
- ISSN
- 2667-2960 (ISSN-L)
- PMC
- PMC9489622
- OpenAlex
- W4281385949
- Cited by
- 37
- References
- 42
- Citations by year
- 2026: 9 · 2025: 7 · 2024: 13 · 2023: 7 · 2022: 1
- FWCI
- 6.39
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the Academy of Consultation-Liaison Psychiatry (acceptedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health
- National Institutes of Health (ZIAMH002922)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- suicide risk screening, care pathways, adult primary care, suicide prevention, general practice, internal medicine, women's health, implementation guidance, clinician preparedness
- MeSH terms
- Suicide Prevention, Adult, Female, Humans, Mass Screening, Primary Health Care, Records, Critical Pathways
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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