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A study was conducted to detect suicide risk in adolescents and adults seeking treatment in an Emergency Department (ED) in the Midwest, as well as to test the reliability, validity, and inter-rater reliability of the 4-item Risk of Suicide Questionnaire (RSQ) developed by Horowitz et al. (2001). The feasibility and need for the ED staff to conduct suicide screening of all patients who present to the ED was also assessed. This study expanded the implementation of the RSQ beyond its initial use with children and adolescents with psychiatric symptoms seeking treatment in a pediatric ED to include adolescent, adult, and geriatric patients in a Level II Trauma Center, regardless of chief complaint or psychiatric history. This study also included the training of Registered Nurses in the ED to administer the RSQ. Participants consisted of a convenience sample of 202 patients comprised of 59 adolescents (age 12 to 24) and 143 adults (over 25), including 36 geriatrics (65 and older). Demographic data, chief complaint, discharge diagnoses, and referrals were also obtained. Psychometric analysis demonstrated a lower than expected degree of reliability and an adequate level of criterion-related validity for the RSQ in this sample. Inter-rater reliability was also established. Approximately 42% of all patients who participated screened positive for suicide risk. Results support suicide screening by nurses as part of the admission assessment to determine suicide risk in all patients who present to an ED.



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