The American Heart Association (AHA) and the American Psychiatric Association 
jointly recommend screening for depression in cardiology clinics. This includes 
screening for suicidality. It is not known how frequently patients disclose 
suicidal thinking (ideation) in this setting, and what proportion of those will 
turn out to have suicidal intent. Patients were screened for depression using a 
protocol identical to the one endorsed by the AHA in a cardiology community 
clinic in Elmhurst (Queens, New York). Depression was assessed using the Patient 
Health Questionnaire. Reports of suicidal ideation were immediately evaluated by 
a mental health professional. We determined the degree to which suicidal 
ideation was identified, the proportion of patients with suicidal intent of 
those reporting suicidal ideation, and the relation between depression and 
suicidal ideation in this setting. One thousand three patients were screened; 
886 had complete Patient Health Questionnaire data. Of those, 12% (109 patients) 
expressed suicidal ideation. Four of those were hospitalized for suicidal intent 
(0.45% of all screened patients). Suicidal ideation and depression were 
correlated (point biserial correlation coefficient 0.478). In conclusion, 
suicidal ideation can and will be identified using the AHA depression screening 
recommendations, but only a very small fraction (0.45%) of screened patients 
will turn out to have suicidal intent. Discovery and stabilization of suicidal 
patients is an important benefit of the screening, but the fact that >12% of all 
screened patients will need to be immediately evaluated for suicidal intent has 
important implications for resource allocation to screening programs.