ED-SAFE Patient Safety Screener 3 (PSS-3)

The ED‑SAFE PSS‑3 is a brief three‑item emergency‑department screen that identifies patients with current suicidal ideation or behavior.

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Over the past 2 weeks, have you felt down, depressed or hopeless
Over the past 2 weeks, have you had thoughts to kill yourself?
In your lifetime, have you ever attempted to kill yourself?

Indikationen

Identify adults in the ED with recent suicidal ideation, attempt, or other suicide risk indicators to trigger brief secondary suicide assessment and safety planning. Supports universal suicide risk screening, as validated in ED-SAFE trials, which showed reduced suicide-related behaviors when positive screens led to structured interventions 1 [Level I evidence]; 2 [Level I evidence].

Hinweise & Vorsichtsmaßnahmen

Flags suicide risk rapidly but requires cautious interpretation. Positive screens identify patients for further assessment, not diagnosis; downstream actions drive benefit. Performance depends on proper implementation: in ED‑SAFE, only screened patients who then received structured safety planning had fewer subsequent suicide‑related behaviors 1 [Level I evidence]. Screening alone offers no risk‑reduction benefit 2 [Level I evidence]. High false‑positive rates may increase workload; ensure clear triage pathways.