Columbia-Suicide Severity Rating Scale (C-SSRS)
The Columbia-Suicide Severity Rating Scale (C-SSRS) is a widely utilized assessment tool designed to evaluate an individual's risk for suicide. Developed collaboratively by researchers at Columbia University and other institutions, the C-SSRS is applicable in various clinical settings and comes in multiple versions to suit different circumstances. Practitioners typically administer it through interviews, but self-assessment is also possible in certain cases. The tool is structured to assess both lifetime and recent suicidal thoughts and behaviors, helping to capture a comprehensive view of a person's mental state.
With a scoring range of 0 to 10, the C-SSRS indicates the severity of suicidal ideation and behavior, where a higher score correlates with increased risk. While the assessment can be administered by individuals without clinical training, proper training is recommended for professionals to ensure accurate application. The C-SSRS is available in over 150 languages, reflecting its global adaptability and commitment to accessibility. By identifying individuals at risk, it plays a critical role in informing appropriate interventions and monitoring, ultimately aiming to reduce the incidence of suicide, which the World Health Organization has highlighted as a significant public health concern.
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Columbia-Suicide Severity Rating Scale (C-SSRS)
Columbia-Suicide Severity Rating Scale (C-SSRS), also called the Columbia Protocol, is a questionnaire that is typically used by mental health professionals to assess a person’s risk for suicide. Various institutions, including Columbia University, developed the assessment to determine a person’s suicide risk. The assessment has numerous forms that practitioners use in different situations. The C-SSRS is formatted to be an interview assessment between a practitioner and the person, but individuals can also conduct self-assessments with the C-SSRS in certain situations. The creators of the C-SSRS recommend that practitioners who use the assessment be trained in its use. Furthermore, the creators explain that the C-SSRS is not meant to be an independent source of assessment. The makers of the C-SSRS allow any group or individual to use the assessment, and it has been published in more than 150 languages.
Overview
The World Health Organization (WHO) has said that roughly 720,000 people die from suicide each year. The WHO and other public health organizations also state that most suicides are preventable. Practitioners can help reduce suicide deaths by assessing patients who are at risk so that they can use interventions for high-risk people.
Researchers at Columbia University, the University of Pennsylvania, and the University of Pittsburgh worked together to develop the assessment to help practitioners identify people at high risk of suicide. They developed different versions of the assessment for use in different situations. The Lifetime/Recent version collects information about a person’s lifetime history of suicidal thoughts and about the person’s recent suicidal behavior. The Since Last Visit version of the assessment determines a person’s suicidal thoughts or behavior since the person’s last visit with the practitioner. The Screener version of the assessment is a shortened version that practitioners can use on a wider range of people than the most specific versions. The practitioner could use a longer version of the assessment if a person is found to have a high risk on the Screener version.
All versions of the C-SSRS ask questions about a person’s suicidal thoughts and suicidal (or self-injurious) behavior. The assessments help practitioners evaluate the severity of the thoughts, the intensity of the thoughts, and potential suicidal behavior. The C-SSRS has a scoring range of 0 to 10, with a score of 0 meaning the person has no suicidal intent or behavior and a score of 10 meaning the person has completed suicide. The scores in between have different levels of intent and suicidal behaviors, and the risk of the person committing suicide increases as the score increases.
Individuals can administer the scale without clinical training or experience. However, Columbia University offers training for administering the scale for practitioners who use the C-SSRS in research or other similar uses. Anyone who administers the C-SSRS should also use a comprehensive evaluation in addition to the findings in the C-SSRS to determine a person’s risk of suicide. Practitioners who use the guide and suspect a person has an increased risk of suicide should use the appropriate interventions and monitoring to help the person.
Bibliography
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Nilsson, Mary E., et al. "Columbia-Suicide Severity Rating Scale Scoring and Data Analysis Guide." Columbia University, 2013, cssrs.columbia.edu/wp-content/uploads/ScoringandDataAnalysisGuide-for-Clinical-Trials-1.pdf. Accessed 20 Nov. 2024.
Posner, K. "Columbia-Suicide Severity Rating Scale (C-SSRS) Columbia University Medical Center." Center for Suicide Risk Assessment, cssrs.columbia.edu/clinical‗practice.html. Accessed 20 Nov. 2024.
Posner, K., et al. "Columbia-Suicide Severity Rating Scale (C-SSRS)." Columbia University, 23 June 2010, cssrs.columbia.edu/wp-content/uploads/C-SSRS‗Pediatric-SLC‗11.14.16.pdf. Accessed 20 Nov. 2024.
Posner, Kelly, et al. "The Columbia-Suicide Severity Rating Scale: Initial Validity and Internal Consistency Findings from Three Multisite Studies With Adolescents and Adults." American Journal of Psychiatry, vol. 168, no. 12, 2011, pp. 1266-77, doi:10.1176/appi.ajp.2011.10111704.
"Resource." Zero Suicide, zerosuicide.edc.org/resources/resource-database/columbia-suicide-severity-rating-scale-c-ssrs. Accessed 20 Nov. 2024.