Determining suicide risk (hint: a screen is not enough).

An individualized assessment is essential to identifying relevant risk factors. Use direct questions, such as, "Have you had any thoughts about killing yourself?" to screen for suicidal ideation. Ask a family member or close friend to ensure that any guns or other lethal means of suicide are inaccessible to the patient at risk. Avoid the use of "no harm" contracts, which are controversial and lack demonstrated effectiveness.