CarePaths now includes the Ask Suicide-Screening Questions (ASQ) and Columbia-Suicide Severity Rating Scale (C-SSRS) as part of its foundational library of clinical tools. These additions are designed to help organizations using CarePaths screen directly for suicide risk, better understand risk level, and further support evidence-based clinical pathways.
This update was developed in partnership with SPiER, a national initiative focused on advancing existing systems so they better support suicide care. SPiER works with electronic health record vendors, health organizations, health information exchanges, and related technology partners to help make suicide care easier to deliver, document, follow, and improve in care settings.
Suicide care has changed significantly over time. The field increasingly recognizes that suicide risk should be discussed directly, not inferred through depression screening. Tools such as the Patient Health Questionnaire-9 (PHQ-9) are important for understanding depression symptoms, and PHQ-9 Item 9 can be an important signal. But suicide risk is not the same thing as depression. A person may be at risk for suicide because of anxiety, trauma, substance use, grief, psychosis, social stressors, cognitive changes, overdose risk, or other life circumstances, even when depression scores do not fully capture the concern.
Because of this, direct suicide screening is imperative. Tools such as the ASQ and the C-SSRS provide structured opportunities to identify suicide risk and determine when additional assessment or follow-up may be needed. The ASQ offers a brief set of questions that can be used as an initial screening tool, while the C-SSRS can be used for screening as well as a more detailed assessment of suicidal ideation and behavior.
The goal is to help existing care systems deliver exceptional suicide care. When suicide risk is identified, the record should make that information visible, guide next steps, and support follow-up so care teams are not relying on memory, separate spreadsheets, or manual workarounds.
Risk stratification helps teams match care to need. A person at higher risk may need more frequent contact, active safety plan review, care coordination, and rapid outreach after a missed appointment. A person at lower or historical risk may need a different response or care. The key point is that the level of risk should help inform the level of support.
For organizations using CarePaths, these tools offer an opportunity to strengthen suicide-safer care screening, identification, and risk assessment.
CarePaths and SPiER are proactively seeking new methods to enhance suicide-safe care within the system. These include clearer language for users, risk-level indicators, reporting features, and practical workflow guidance for teams and organizations.
Moving forward, the focus is on helping CarePaths EHR users understand the available tools and how to incorporate them effectively into their specific settings, workflows, and populations. For organizations using CarePaths, SPiER offers training, technical assistance, and workflow support related to the ASQ, C-SSRS, risk stratification, safety planning, and broader suicide-safe care initiatives.
To learn more or request support, contact:
Kelly Samuelson, MSW, LADC
Project Director, SPiER
ksamuelson@zerooverdose.org
