Suicide risk assessment is an important task in clinical psychiatry. Interestingly, several suicide risk assessmet tools have been developed but their usability suffers from distinct problems. First, they do not have a sufficient positive predictive power, with many false positives. Second, the scales often focus on the assessment of current risk markers, such as suicidal ideation, omitting well known long term risk factors. Third, clinicians are reluctant to assess suicidality, because they are uncomfortable with severly suicidal patients, due to a lack of standard procedures of management in outpatient and inpatient situations. But it has been suggested to include suicide assessment in the DSM-5, which may confront us with the need of assessment and management of suicidal patients in the near future.