Given that "50 percent of suicides see their primary care doctor in the month before they die," Posner said doctors should be asking their patients about suicide "the way we monitor for blood pressure."
One of the advantages of having a simple question-based tool, most of which can be administered in "a minute or two," is that it can be used by non-professionals, such as peer counselors, she said. In addition, men and women can complete an electronic version in the privacy of their own homes.
Suicide is the third leading cause of death among people under the age of 24, many of whom may not have regular access to a doctor, let alone mental health counseling.
"We know prevention depends upon appropriate screening," Posner said. To that end, she said her ultimate goal is "universal screening" for suicide risk in the schools, which "helps us to identify those people who really need intervention or further evaluation."
Targeted interventions could not just save lives, but save scarce resources, she said. Already, the Columbia rating scale is being used in schools around the country, including New York City public schools.
Dr. Adam Kaplin, assistant professor of psychiatry and neurology at Johns Hopkins Medical institutions in Baltimore, welcomed the new study, calling it "the most comprehensive effort to actually validate this scale in three different settings and to really hammer away at how good a scale (it is)."
The scale represents an attempt to distinguish between "the millions of people who have thoughts in any given year about wanting to call it quits and commit suicide," and the estimated 30,000 who die by their own hands.
"For my money, this is the best application of a scale from one of the best groups studying suicide in the country," he said. "It is the best-tested tool out there."
"I think it's promising. It's worth people trying in their practices and in their research and seeing how it works for them," said adolescent suicide specialist Nadine Kaslow, chief psychologist at the Emory University School of Medicine in Atlanta. "We could certainly benefit from better tools. No question, our assessment armamentarium needs to be strengthened."
Despite decades of public health agency discussions about lowering suicide rates, suicides and attempted suicides remain "a serious public health problem," Koslow said.
"One of the things you want to know is who are people at risk for suicidal behavior?" she said. "You find out somebody's at risk and then you can employ useful prevention and intervention strategies. We have some hopeful strategies in prevention and intervention, but we still have a long way to go."