Patient feedback in the form of Routine Outcomes Monitoring (ROM) reduces adverse health outcomes by regularly reporting information on therapeutic progress to staff and patients. It is particularly well-suited to the assessment of suicidality for two reasons. First, suicide and associated self-harm and serious adverse health outcomes that warrant preventive interventions. Second, the desire to self-harm or to attempt suicide is not a stable trait, but it is a state that waxes and wanes in intensity. The present chapter will outline a case example where ROM was used to monitor the risk of suicide during a course of inpatient and day patient treatment for mental health problems. It will highlight the value of the monitoring providing a common language of communication between the patient and the treatment team. Additionally, the case study will highlight the current limitations of ROM with respect to suicide prevention. The chapter will conclude with consideration of future developments to address the weaknesses that we have is knowing which preventive intervention to deliver at what time to which patient.