I've just switched back. I'm still trying to figure out the headset because I didn't test this one—my apologies.
The ASARI and the HEARTSMAP tools, when used, can be really helpful in both documenting risk and communicating it—as well as the HEARTSMAP tool in its psychosocial assessment. The HEARTSMAP tool actually calculates what an emergency physician could consider next as a course of action and who to consult with, not just with regard to mental health but for social and physical needs, youth health needs and these types of things. It would be really helpful to be used.
As for risk assessment in general, it's very hard to predict who will die by suicide and who won't. In fact, there is no risk prediction system that gets better than a positive predictive value of 1%. Therefore, risk assessment is often trying to figure out what the risk factors are that make suicide more likely and what the protective factors are that make it less likely, trying to cut away as many risk factors as possible and add as many protective factors as possible. This is something that every human working with kids can do. I see a lot of efforts zeroing in on prediction, and I wish the science were there, but it's just not. However, risk reduction and protection increase are very achievable goals in any setting, including emergency departments.