To test feasibility of a routine screening tool and to examine factors associated with suicide and suicidal behaviors. Subjects included outpatients with serious mental disorders. One hundred and sixteen clinicians routinely screened randomly selected adult clients for suicide risk during a 6-month period. Forty-three (9%) clients reported thoughts to hurt/kill self (screened positive), which spurred enhanced clinical intervention. There was no increase in frequency of suicide attempts. A history of multiple suicide attempts, recent stressful events, and present hopelessness were associated with a positive risk screen, clinician rating of risk, or altered treatment plan. It is feasible to safely implement a brief routine screening process in psychiatric outpatient settings. Future research is needed to determine overall utility for routine screening.