Suicide risk screening for threat assessment teams: Suicide Risk Screening in School Threat Assessment
Why threat assessment teams should screen for suicide risk, how the free NIMH asQ screener works, what each result means, and what to do next at school.
A behavioral threat assessment asks whether a student is on a path toward harming someone. Often the answer turns out to involve harm to themselves. A student who has made a threat may also be hopeless, desperate, or thinking about suicide, and some of the most worrying cases involve both. This guide explains why threat assessment teams screen for suicide risk, how the free NIMH asQ screener works, and what to do with each result.
If a student is in immediate danger, stay with them and call 911. For urgent help, call or text 988. Your district's crisis protocol comes first.
Why suicide risk is part of threat assessment
The U.S. Secret Service National Threat Assessment Center (NTAC) organizes every assessment around investigative themes. One of them asks whether the student is experiencing hopelessness, desperation, or despair, including suicidal thoughts or gestures. In NTAC's study of school attacks, suicidal thoughts and self-harm were common among the attackers in the period before their attack.
That doesn't mean a student who is thinking about suicide is a threat to others. Most are not. It means a team that only asks about harm to others can miss what a student most needs. See Threat Assessment Investigative Themes for the full list.
The NIMH asQ screener
The Ask Suicide-Screening Questions (asQ) is a free screening tool from the National Institute of Mental Health. It was validated with youth and adults in medical settings, and NIMH notes it can also be used with youth in other settings, such as school nursing offices. It takes about 20 seconds.
- Four questions ask, in plain language, about recent wishes to be dead, feeling others would be better off, recent thoughts of suicide, and any past attempt.
- If the student answers yes to any of the four, a fifth question asks whether they are having thoughts of killing themselves right now.
- If the student won't answer, treat it as a positive screen.
Use the exact wording from the NIMH asQ toolkit, which also has versions in other languages.
What each result means, and what to do next
| Result | What it means | Next steps at school |
|---|---|---|
| Negative screen | No to all four questions | No intervention for suicide risk is needed now. Clinical judgment can override a negative screen; screen again if things change. |
| Non-acute positive | Yes to any of the four, no to the fifth | A school mental health professional does a brief suicide safety assessment to decide whether a full mental health evaluation is needed, and when. Contact the family, talk about safe storage, and make a safety plan. |
| Acute positive | Yes to the fifth question | Imminent risk. Stay with the student and remove anything they could use to hurt themselves. Follow your crisis protocol for an urgent mental health evaluation (mobile crisis, 988, or the emergency room). Call 911 if there's immediate danger. Contact the family unless that would put the student at risk. |
Making it part of the team's process
- Write it into your procedures. Decide when the team screens, which trained staff do it, and which tool you use.
- Screen in private, and explain why. Tell the student you ask these questions because you care about their safety.
- Record the result and every action taken, such as who was contacted and whether a safety plan was made, in the student's case.
- Make a safety plan with any student who screens positive, and give them crisis lines they can use any time.
- Talk with the family about safe storage of medications and firearms. Reducing access to lethal means is one of the most effective ways to prevent suicide.
- Add follow-up to the management plan: check-ins, counseling referrals tracked until the first appointment, and a date to screen again.
How VeriThreat helps
VeriThreat puts suicide risk screening in the threat assessment case. The team can give the asQ step by step and see the result scored, with the next steps for that result. It can also record results from the Columbia (C-SSRS) or another screener, make a safety plan with the student, and keep 988 and the district's crisis contacts on every case. See the platform.
Sources
- National Institute of Mental Health, Ask Suicide-Screening Questions (asQ) Toolkit
- U.S. Secret Service National Threat Assessment Center, Protecting America's Schools (2019) and Enhancing School Safety Using a Threat Assessment Model (2018)
- 988 Suicide & Crisis Lifeline
This guide is general information, not clinical or legal advice. Follow your district's crisis protocol and the judgment of your school mental health professionals.
Frequently asked questions
Should every student in a threat assessment be screened for suicide risk?
Teams should always ask about it. NTAC lists hopelessness, desperation, and suicidal thoughts as an investigative theme, so every assessment should consider it. Whether a formal screener is used, and who uses it, is set by your district's policy and mental health staff.
Who can give the asQ at school?
NIMH designed the asQ to be given by trained staff such as nurses, and notes it can be used with youth outside medical settings, such as school nursing offices. Districts decide which staff are trained to screen. A positive screen always goes to a mental health professional.
Does a negative screen mean the student is safe?
A negative screen means no intervention for suicide risk is needed at that time. Clinical judgment can always override it, and the student should be screened again if things change.
Can we use the Columbia (C-SSRS) instead?
Yes. Many districts use the Columbia Suicide Severity Rating Scale. What matters is a validated tool, trained staff, and a clear path from each result to the next step.