Narrator
In this scenario, we’ll observe how a nurse and physician in a rural clinic respond when a youth screens positive on a suicide-risk screening.
You’ll hear how each step of the process—from screening to assessment to action—is explained out loud to the young person and caregiver.
Nurse Jackson
Hi, Eli. I’m going to ask you a few quick questions that we ask all teens during their visit. Some of these questions are about mood, safety, and how you’ve been feeling lately. There are no right or wrong answers—it just helps us understand how to best support you.
Narrator
The nurse is administering the Ask Suicide-Screening Questions, or ASQ, a brief evidence-based screening tool used in medical settings.
Eli
Yes, I have, like... a few months ago.
Mom
Oh Eli, I didn't know that you felt that way. I am so sorry. Thank you for speaking up.
Nurse Jackson
Thank you for answering honestly. You mentioned that you’ve tried to hurt yourself before. I really appreciate you sharing that—it takes courage.
Because you said yes to that question, I’m going to have Dr. Patel come in so we can talk a little more and make sure you’re safe today, okay?
Narrator
A positive response on the ASQ—especially indicating a past suicide attempt—triggers a more detailed suicide-risk assessment.
Dr. Patel now joins the conversation to continue with a structured follow-up using the Columbia Suicide Severity Rating Scale, often called the C-SSRS.
Dr. Patel
Hi Eli, I’m Dr. Patel. Nurse Jackson told me you were really open during your screening, and I’m glad you felt comfortable sharing.
I’d like to ask a few more questions to understand what’s been going on and how we can help you stay safe.
Some of these questions might sound serious, but I ask them of everyone who tells me they’ve had thoughts like this.
Narrator
Dr. Patel uses the short C-SSRS first to confirm whether immediate risk is present.
Eli’s answers show ongoing suicidal thoughts, a plan, and access to means.
Dr. Patel now proceeds to complete the SAFE-T framework and the full C-SSRS to guide next steps.
Dr. Patel
Eli, thank you for talking through that with me.
Based on what you’ve shared, I’m concerned about your safety right now. You’ve mentioned having a plan and a way to carry it out. That means your level of risk is high, and we want to keep you safe.
Narrator
After completing the assessments, Dr. Patel determines that Eli’s risk is high and that immediate safety steps are needed.
Dr. Patel
Right now Eli and Mom, our main goal is to make sure Eli stays safe. I’m going to contact crisis services and arrange for transportation to the nearest hospital so he can get more support right away. We’ll stay with you until help arrives, and we’ll make sure you know exactly what’s happening next.
Mom
Thank you, both Dr. Patel and Nurse Jackson.
Narrator
In this brief encounter, several key tools were used:
The ASQ identified risk.
The short C-SSRS confirmed suicidal thoughts, plan, and means.
The SAFE-T and full C-SSRS structured the assessment and guided next steps.
When a youth is found to be at high risk, the immediate priority is safety—contacting crisis resources, arranging secure transport, and providing calm, compassionate communication throughout.
Narrator
This scenario highlights how even in a small rural clinic, providers can use evidence-based tools and clear, caring dialogue to respond quickly and safely when a young person is at risk for suicide.
