# Patient Safety Screener 3 (PSS-3)

PSS-3

Status: LIVE
Price: $0.005 USDC
`GET /api/calc/pss_3`
HTML: https://magentlab.com/docs/pss-3
Markdown: https://magentlab.com/docs/pss-3.md

Not a medical device. Not a diagnosis, dose, or listing recommendation.

## What it computes

Apply Boudreaux 2015 PSS-3 from four caller-assigned flags and return screen_positive using the same-group ED-SAFE definition used with PSS-3 (Boudreaux 2016 Am J Prev Med): ideation past 2 weeks or attempt within 6 months. Depression is a segue and is not factored into screening results. magent does not interview the patient. Not a diagnosis. Not C-SSRS.

## When to use

When an agent has already assigned Boudreaux 2015 PSS-3 flags (2-week depressed mood, 2-week suicidal ideation, lifetime attempt, and whether the most recent attempt was within 6 months) and needs the published screen_positive result, not a suicide-risk diagnosis, a C-SSRS interview, or a clinical interview.

## When not to use

- Not a medical device and not a diagnosis or treatment order.
- magent does not interview the patient. The caller assigns four bools.
- depressed_mood is the Boudreaux 2015 2-week down/depressed/hopeless segue and is not factored into screening results.
- screen_positive uses the same-group ED-SAFE definition used with PSS-3 (Boudreaux 2016 Am J Prev Med): ideation past 2 weeks or attempt within 6 months. ToolRecord citation is Boudreaux 2015 (PSS-3 validation).
- If lifetime_attempt is false, attempt_within_6_months must be false. This is not C-SSRS.

## Formula

```
screen_positive iff ideation_2_weeks OR (lifetime_attempt AND attempt_within_6_months); depressed_mood (past 2 weeks down/depressed/hopeless) is a segue item and is not factored into screening results; this positive rule is the same-group ED-SAFE definition used with PSS-3 (Boudreaux 2016 Am J Prev Med: ideation past 2 weeks or attempt within 6 months); if lifetime_attempt is false then attempt_within_6_months must be false; four caller-assigned bools; magent does not interview the patient; not a diagnosis; not C-SSRS
```

## Citation

[The Patient Safety Screener: Validation of a Brief Suicide Risk Screener for Emergency Department Settings](https://doi.org/10.1080/13811118.2015.1034604)
Boudreaux ED, Jaques ML, Brady KM, Matson A, Allen MH
Arch Suicide Res. 2015;19(2):151-160
DOI: [10.1080/13811118.2015.1034604](https://doi.org/10.1080/13811118.2015.1034604)

## Worked example

### All flags false

Given: `attempt_within_6_months=false, depressed_mood=false, ideation_2_weeks=false, lifetime_attempt=false`

1. depressed_mood false (segue; not in screen_positive)
2. ideation_2_weeks false
3. lifetime_attempt false and attempt_within_6_months false
4. screen_positive false


### Ideation in the past 2 weeks

Given: `attempt_within_6_months=false, depressed_mood=false, ideation_2_weeks=true, lifetime_attempt=false`

1. ideation_2_weeks true
2. screen_positive true (ED-SAFE / Boudreaux 2016: ideation past 2 weeks)


### Attempt within 6 months

Given: `attempt_within_6_months=true, depressed_mood=false, ideation_2_weeks=false, lifetime_attempt=true`

1. lifetime_attempt true and attempt_within_6_months true
2. ideation_2_weeks false
3. screen_positive true (ED-SAFE / Boudreaux 2016: attempt within 6 months)


## Also searched as

- PSS-3
- Patient Safety Screener
- Patient Safety Screener 3
- PSS-3 suicide screen
- ED-SAFE PSS-3
- Boudreaux PSS-3
- Patient Safety Screener-3
- ED suicide screener

## Parameters

- `depressed_mood` (boolean, required): Over the past 2 weeks, felt down, depressed, or hopeless (Boudreaux 2015 PSS-3 segue item). true or false as assigned by the caller. Not factored into screen_positive. magent does not interview the patient.
- `ideation_2_weeks` (boolean, required): Active suicidal ideation in the past 2 weeks (Boudreaux 2015: over the past 2 weeks, thoughts of killing yourself). true or false as assigned by the caller. screen_positive is true if this is true. magent does not interview the patient.
- `lifetime_attempt` (boolean, required): Lifetime suicide attempt (Boudreaux 2015: ever attempted to kill yourself). true or false as assigned by the caller. If false, attempt_within_6_months must be false. magent does not interview the patient.
- `attempt_within_6_months` (boolean, required): Most recent suicide attempt was within 6 months (Boudreaux 2015 timing follow-up). true or false as assigned by the caller. Always required. If lifetime_attempt is false this must be false. screen_positive is true when lifetime_attempt and this are both true. magent does not interview the patient.

## Bulk (POST)

POST the same path with a JSON items array. The first item is the GET unit; each additional item is $0.002. Invalid items return HTTP 400 before settlement.

Method: `POST /api/calc/pss_3`
Max items: 25
Price: unit_amount + extra_item_amount * (n - 1) (unit 5000 atomic, extra 2000 atomic)
Status: PREVIEW

- 1 to 25 items. Each item uses the same keys as the GET query parameters.
- POST of 1 item costs the same as GET. Lists longer than 25: chunk into multiple POSTs. Extra items still execute; do not pad dummy rows.
- The first invalid item fails the whole request (index in the 400 JSON). You are not charged.
- HTTP 200 is {count, path, items}. Each items[i] is the GET 200 body for that row.
- Catalog misses (empty matches, found=false) stay paid 200s inside that slot.
- x402 resource URL is this path plus n and body_sha256. Browsers that prefer text/html get the same paywall as GET; Pay retries POST with the same items.

Example request:

```json
{
  "items": [
    {
      "attempt_within_6_months": "false",
      "depressed_mood": "false",
      "ideation_2_weeks": "false",
      "lifetime_attempt": "false"
    },
    {
      "attempt_within_6_months": "false",
      "depressed_mood": "false",
      "ideation_2_weeks": "false",
      "lifetime_attempt": "false"
    }
  ]
}
```

Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/pss-3

Example 200:

```json
{
  "count": 2,
  "path": "/api/calc/pss_3",
  "items": [
    {
      "components": [
        {
          "factor": "depressed_mood",
          "met": false
        },
        {
          "factor": "ideation_2_weeks",
          "met": false
        },
        {
          "factor": "lifetime_attempt",
          "met": false
        },
        {
          "factor": "attempt_within_6_months",
          "met": false
        }
      ],
      "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
      "citation": {
        "authors": "Boudreaux ED, Jaques ML, Brady KM, Matson A, Allen MH",
        "doi": "10.1080/13811118.2015.1034604",
        "id": "boudreaux-2015",
        "pmid": "25826715",
        "source": "Arch Suicide Res. 2015;19(2):151-160",
        "title": "The Patient Safety Screener: Validation of a Brief Suicide Risk Screener for Emergency Department Settings"
      },
      "formula": "pss_3",
      "formula_expression": "screen_positive iff ideation_2_weeks OR (lifetime_attempt AND attempt_within_6_months); depressed_mood (past 2 weeks down/depressed/hopeless) is a segue item and is not factored into screening results; this positive rule is the same-group ED-SAFE definition used with PSS-3 (Boudreaux 2016 Am J Prev Med: ideation past 2 weeks or attempt within 6 months); if lifetime_attempt is false then attempt_within_6_months must be false; four caller-assigned bools; magent does not interview the patient; not a diagnosis; not C-SSRS",
      "screen_positive": false,
      "attempt_within_6_months": false,
      "depressed_mood": false,
      "ideation_2_weeks": false,
      "lifetime_attempt": false
    },
    {
      "components": [
        {
          "factor": "depressed_mood",
          "met": false
        },
        {
          "factor": "ideation_2_weeks",
          "met": false
        },
        {
          "factor": "lifetime_attempt",
          "met": false
        },
        {
          "factor": "attempt_within_6_months",
          "met": false
        }
      ],
      "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
      "citation": {
        "authors": "Boudreaux ED, Jaques ML, Brady KM, Matson A, Allen MH",
        "doi": "10.1080/13811118.2015.1034604",
        "id": "boudreaux-2015",
        "pmid": "25826715",
        "source": "Arch Suicide Res. 2015;19(2):151-160",
        "title": "The Patient Safety Screener: Validation of a Brief Suicide Risk Screener for Emergency Department Settings"
      },
      "formula": "pss_3",
      "formula_expression": "screen_positive iff ideation_2_weeks OR (lifetime_attempt AND attempt_within_6_months); depressed_mood (past 2 weeks down/depressed/hopeless) is a segue item and is not factored into screening results; this positive rule is the same-group ED-SAFE definition used with PSS-3 (Boudreaux 2016 Am J Prev Med: ideation past 2 weeks or attempt within 6 months); if lifetime_attempt is false then attempt_within_6_months must be false; four caller-assigned bools; magent does not interview the patient; not a diagnosis; not C-SSRS",
      "screen_positive": false,
      "attempt_within_6_months": false,
      "depressed_mood": false,
      "ideation_2_weeks": false,
      "lifetime_attempt": false
    }
  ]
}
```

## Response fields

- `formula` (string): pss_3
- `formula_expression` (string): Published PSS-3 / ED-SAFE screen-positive rule
- `depressed_mood` (boolean): Boudreaux 2015 2-week down/depressed/hopeless segue as assigned by the caller. Not in screen_positive.
- `ideation_2_weeks` (boolean): Active suicidal ideation in the past 2 weeks as assigned by the caller
- `lifetime_attempt` (boolean): Lifetime suicide attempt as assigned by the caller
- `attempt_within_6_months` (boolean): Most recent attempt was within 6 months as assigned by the caller
- `screen_positive` (boolean): true iff ideation_2_weeks or (lifetime_attempt and attempt_within_6_months). Same-group ED-SAFE definition used with PSS-3 (Boudreaux 2016 Am J Prev Med). Depression is not factored in. Not a diagnosis. Not C-SSRS.
- `components` (array): Per-flag Tree rows depressed_mood, ideation_2_weeks, lifetime_attempt, attempt_within_6_months with factor and met
- `citation` (object): Boudreaux 2015 Arch Suicide Res citation
- `disclaimer` (string): Not-a-device notice

## Example JSON

Frozen fixture. Not a live lookup.

```json
{
  "components": [
    {
      "factor": "depressed_mood",
      "met": false
    },
    {
      "factor": "ideation_2_weeks",
      "met": false
    },
    {
      "factor": "lifetime_attempt",
      "met": false
    },
    {
      "factor": "attempt_within_6_months",
      "met": false
    }
  ],
  "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
  "citation": {
    "authors": "Boudreaux ED, Jaques ML, Brady KM, Matson A, Allen MH",
    "doi": "10.1080/13811118.2015.1034604",
    "id": "boudreaux-2015",
    "pmid": "25826715",
    "source": "Arch Suicide Res. 2015;19(2):151-160",
    "title": "The Patient Safety Screener: Validation of a Brief Suicide Risk Screener for Emergency Department Settings"
  },
  "formula": "pss_3",
  "formula_expression": "screen_positive iff ideation_2_weeks OR (lifetime_attempt AND attempt_within_6_months); depressed_mood (past 2 weeks down/depressed/hopeless) is a segue item and is not factored into screening results; this positive rule is the same-group ED-SAFE definition used with PSS-3 (Boudreaux 2016 Am J Prev Med: ideation past 2 weeks or attempt within 6 months); if lifetime_attempt is false then attempt_within_6_months must be false; four caller-assigned bools; magent does not interview the patient; not a diagnosis; not C-SSRS",
  "screen_positive": false,
  "attempt_within_6_months": false,
  "depressed_mood": false,
  "ideation_2_weeks": false,
  "lifetime_attempt": false
}
```

## Errors

- HTTP 400 `invalid_pss3`: PSS-3 needs Boudreaux 2015 depressed_mood, ideation_2_weeks, lifetime_attempt, and attempt_within_6_months as true or false. Returned before settlement; you are not charged.
- HTTP 400 `invalid_items`: POST body must be a JSON object with only an items array Returned before settlement; you are not charged.
- HTTP 400 `invalid_item_count`: items must be an array of 1 to 25 objects Returned before settlement; you are not charged.
- HTTP 400 `invalid_item`: each items entry must be a JSON object Returned before settlement; you are not charged.

Shared HTTP 402 and 503: https://magentlab.com/docs/payments

## Related tools

- [PHQ-9](https://magentlab.com/docs/phq-9) — Sum nine caller-assigned Kroenke 2001 PHQ-9 integers (0-3) and return the published total (max 27), severity cutpoints, and ≥10 screen.
- [GAD-7](https://magentlab.com/docs/gad-7) — Sum seven caller-assigned Spitzer 2006 GAD-7 integers (0-3) and return the published 0-21 total, 5/10/15 severity cuts, and ≥10 case-finding flag.

## Payment

Unpaid requests return HTTP 402 even if query parameters or POST items are missing or invalid, so CDP and agents can index the path. After a PAYMENT-SIGNATURE, invalid params return HTTP 400 JSON before settlement. magent does not charge. Fix the params, then request a new 402 quote for that complete URL. Catalog misses (empty matches, found=false) are valid paid 200s.

- GET the tool with Accept: application/json (do not send Accept: text/html unless you want the human paywall).
- HTTP 402 means you have not paid. Decode the base64 PAYMENT-REQUIRED header. HTTP 503 is not a new quote.
- Sign accepts[0] (exact, EIP-3009) with validBefore = now + maxTimeoutSeconds (600 seconds), or accepts[1] (batch-settlement deposit/voucher) on product GET. Ping and POST {items} stay exact. Magent retries transient facilitator 429/5xx before answering.
- Retry the same URL with PAYMENT-SIGNATURE (base64 JSON of accepted and payload). Magent attaches canonical extensions.bazaar on CDP verify/settle; echoing 402 bazaar is optional.
- Success is HTTP 200 JSON plus PAYMENT-RESPONSE. exact settles before the tool. batch-settlement verifies (and deposit-settles) before the tool and commits the charge after HTTP 2xx. HTTP 503: retry the same PAYMENT-SIGNATURE. Mint a new exact nonce only after a new HTTP 402.

- offered `exact` on eip155:8453: Fixed-price USDC on Base. The buyer authorizes the advertised amount (EIP-3009). magent settles before the tool runs (paymentFlow upfront). extra.assetTransferMethod=eip3009 extra.paymentFlow=upfront.
- offered `batch-settlement` on eip155:8453: Payment-channel vouchers claimed later in batches. Exact stays accepts[0]. Same-path POST {items} is still exact. extra.assetTransferMethod=eip3009 extra.paymentFlow=authorization.

- not offered `upto`: Not offered. Usage-based: buyer authorizes a ceiling, seller settles the actual amount after work. Reserved for a future metered tool. Not for current calculators or code search.

Same-path POST {items} is still scheme exact: one EIP-3009 authorization for GET unit plus $0.002 per extra item. That is not x402 batch-settlement (payment channels / vouchers).

Shared HTTP 402 and 503 table: https://magentlab.com/docs/payments

Stdio MCP (one process per host): https://magentlab.com/docs/mcp

## Guarantees

- HTTP 402 is unpaid, including a missing query. After PAYMENT-SIGNATURE, invalid parameters return HTTP 400 before settlement. You are not charged. HTTP 402 never includes the tool JSON.
- exact: settlement finishes before the tool (paymentFlow upfront). batch-settlement: verify/deposit before the tool; chargedCumulativeAmount commits after HTTP 2xx. Uncertain or failed settlement fails closed (HTTP 503). Retry the same PAYMENT-SIGNATURE.
- HTTP 402 is unpaid only. Do not sign a second authorization because of a 503.
- Execution is timeout-bounded and concurrency-capped.
- Calculator inputs are stored encrypted for allowlisted operators (Magent Console). They are not in public logs, SSH lookups, catalog, or rollups. Request logs store path without query.