Enhancing suicide prevention: evaluating the impact of universal suicidal ideation screening in primary care
Date
2025
Authors
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Publisher
University of Delaware
Abstract
Background: Universal suicidal ideation (SI) screenings mitigate suicide risk through identification, early intervention, and monitoring. Despite the literature supporting the efficacy of universal SI screenings in primary care, many clinics indirectly assess suicide risk with depression screenings without supportive evidence. Purpose: This project explores whether direct screening for SI in primary care yields an accurate identification of SI, with secondary aims of increasing suicide risk mitigation interventions and evaluating the involved primary care providers’ (PCPs) perceptions of universal SI screening. Methods: A prospective quantitative analysis of universal SI screening was completed over eight weeks in a single primary care clinic. Four weeks of baseline suicide risk data using the Patient Health Questionnaire-2 (PHQ-2) preceded four weeks of universal SI screening with the Colombia Suicide Severity Rating Scale (C-SSRS). Descriptive statistics, chi-square tests, and Fisher’s exact tests were used to evaluate SI identification, risk mitigation intervention use, and PCPs’ perceptions of project feasibility and utility. Results: There was a significant decrease in the identification of SI with the C-SSRS compared to suicide risk identified with the PHQ-2 (?2 =7.11, ? = 0.008, ? = 0.114), highlighting the precision of the C-SSRS. Additionally, suicide risk mitigation interventions increased by 26% from baseline to intervention phase. All the involved PCPs believed the screenings to be moderately beneficial or very beneficial. Conclusions & Implications: This study supports the evidence of the applicability of universal SI screenings in primary care settings and highlights the nuances present in SI screening.
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Keywords
Primary care, Suicidal ideation, Suicide prevention, Suicide screening, Universal screening