Columbia-Suicide Severity Rating Scale
A set of plain-language questions to identify suicide risk, assess its severity and immediacy, and determine what support the patient needs.
- Category
- Suicide risk
- Recall period
- Depends on version (e.g. lifetime/recent, since last visit)
On this page
Licensed scale
This scale is under licence, so its items cannot be shown here. The information on this page describes it; contact the rights holder to obtain the instrument.
Alternatives you can administer here
If the patient is in immediate danger, call 112. TelefonSeelsorge (Germany): 0800 111 0 111 or 0800 111 0 222, free of charge, any time.
Introduction
The Columbia-Suicide Severity Rating Scale (C-SSRS), also called the Columbia Protocol, supports suicide risk assessment through simple questions about suicidal thoughts and behaviour. The answers show whether the patient is at risk, how severe and immediate that risk is, and what level of support is needed.
What it measures
The C-SSRS asks about suicidal ideation, including its intensity, and about suicidal behaviour such as actual, interrupted and aborted attempts and preparatory acts. Several versions exist: a full version, a shorter screener, versions for recent or lifetime history, and a version for use since the last visit. Some screener versions include triage guidance.
When to use it
Clinicians use the C-SSRS when suicidal thoughts are suspected or mentioned, for example after a positive answer to item 9 of the PHQ-9 or item 19 of the ISR. Its developers state that it is suitable for all ages and special populations in different settings.
Origin
The C-SSRS was developed by Kelly Posner and colleagues from Columbia University, the University of Pennsylvania and the University of Pittsburgh. It is disseminated by the Columbia Lighthouse Project.
Validation
According to the Columbia Lighthouse Project, a large body of research supports the C-SSRS. In a Swedish psychiatric emergency department, the screen version predicted suicide during follow-up (Bjureberg et al., 2021). The scale is available in more than 100 country-specific languages, including a linguistically validated translation for Germany.
Limitations
Use of the C-SSRS is free for community and healthcare settings and for publicly funded or nonprofit research, but electronic versions on websites or in apps require a licence. The official versions are available from the Columbia Lighthouse Project. Any positive answer requires a direct clinical assessment.
Frequently asked questions
- Why can't the C-SSRS be completed here?
- Electronic versions of the C-SSRS require a separate licence. The official versions are available from the Columbia Lighthouse Project.
- What if the patient is in immediate danger?
- Call 112. In Germany, TelefonSeelsorge can be reached free of charge at any time: 0800 111 0 111 or 0800 111 0 222.
References
- The Columbia Lighthouse Project. Columbia-Suicide Severity Rating Scale (C-SSRS).
- Bjureberg J, et al. Columbia-Suicide Severity Rating Scale Screen Version: initial screening for suicide risk in a psychiatric emergency department. Psychological Medicine. 2021.
Licence & attribution
© The Research Foundation for Mental Hygiene, Inc.
Free for community and healthcare settings and nonprofit research (paper). Electronic versions require a licence (via Clario). The official versions can be downloaded from Columbia.