PRISM-S offers a brief, easy-to-administer, and valid method to assess patients' suicidality. The simple instruction facilitates its use in other languages and other cultures as well. The acceptance by patients and health professionals was good, with no one refusing to complete the task.

In routine clinical practice the assessment of suicidality proves to be difficult and complex. The aim of the present study was to examine if PRISM can be used to measure validly the person's subjectively perceived suicidality. The nonverbal visualization technique PRISM (Pictoral Representation of Illness and Self Measure) has been developed by Büchi et al. (2002) to evaluate the perceived burden of suffering due to physical illness. The adapted version of PRISM used in our study is called PRISM-S (Pictoral Representation of Illness and Self Measure - Suicidality). 156 eligible inpatients, admitted voluntarily to the crisis intervention centre Winterthur, participated in the study. We used as gold standards the well established assessment tools the Beck Scale of Suicide Ideation (BSS) and the Depressive Symptome Inventory - Subscale (DSI-SS). The results showed high correlations between PRISM-S and the BSS (r = - 0,73) and the DSI-SS scores (r = - 0,76). Clinicians, general practitioners, psychiatrists and psychologists receive with PRISM-S a valid suicidality assessment tool that is very brief and easy to administer in clinical settings.

Suicide rates in Switzerland and most other countries are higher among the elderly than among the population as a whole. Suicidality in the old age is commonly associated with the presence of a mental disorder, especially depression. Medical doctors in primary healthcare have outstanding prominence in detecting suicidal states within elderly patients, because of their common long-standing and confidential relationship and the fact that suicidality is often concealed behind somatisation or other medical complaints. A new practical approach called PRISM-S task enables an assessment of the degree of suicidality in less than five minutes with a simple, visual instrument. Besides the importance of public mental health measures PRISM-S offers a brief, easy-to-administer method for all healthcare professionals to assess suicidality in adult patients (18-65 years). Further investigation will explore its specific usefulness for elderly patients (over 65 years).