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Columbia Suicide Severity Rating Scale (Screener)

Screens suicidal ideation and behaviour to triage risk level.

Columbia Suicide Severity Rating Scale (Screener)
1. Wish to be dead
2. Non-specific active suicidal thoughts
3. Active thoughts with any method (no plan/intent)
4. Active thoughts with some intent to act
5. Active thoughts with specific plan and intent
6. Suicidal behaviour (ever / recent)
ResultNo ideation or behaviour endorsed

No positive items; continue clinical judgement.

Triage category
No ideation or behaviour endorsed

When to use

  • Standardised screening for suicidal ideation and behaviour to guide triage and referral.

Formula

Hierarchical logic: a positive item 4, 5 or 6 (intent, plan or behaviour) = high risk; item 3 alone = moderate; item 1 or 2 alone = low; none = no risk endorsed.

Pearls and pitfalls

  • This is a screen — a positive answer, especially to behaviour or plan/intent, mandates fuller assessment.
  • Recent (past-month) behaviour or ideation carries greater acute concern than lifetime-only items.

References

  1. Posner K, et al. Am J Psychiatry. 2011;168(12):1266-77.