In this post, I link to and excerpt from Calculated Decisions: Columbia-Suicide Severity Rating Scale (C-SSRS) [PubMed Abstract] [Full-Text HTML] [Full-Text PDF]. Emerg Med Pract. 2019 May 1;21(5):CD3-4.
All that follows is from the above resource:
The Columbia-Suicide Severity Rating Scale (C-SSRS) screens for suicidal ideation and behavior.
- The Columbia-Suicide Severity Rating Scale (C-SSRS) score is based on the patient’s responses to screening questions, but it also allows for integration of information from other sources (eg, family and friends, healthcare professionals, hospital records, or coroner’s report).
- The C-SSRS has been validated in emergency settings (ie, to triage patients in the emergency department) but also has some validation in the outpatient psychiatry setting (Viguera 2015).
Why to Use
Suicide risk assessment is complex; the C-SSRS can assist clinicians in evaluation of patients in the emergency department to predict overall suicide risk and the need for admission. The C-SSRS has been extensively validated in several subpopulations, including children and adolescents, military veterans with concomitant posttraumatic stress disorder, and psychiatry outpatients.
The C-SSRS is recommended by the United States Food and Drug Administration for clinical trials (United States Food and Drug Administration 2012), and has been adopted by the Centers for Disease Control and Prevention to define and stratify suicidal ideation and behavior (Crosby 2011).
When to Use
The C-SSRS should be used in patients in the emergency department for whom there is a concern for suicidality.
Protocols vary by institution, but most recommend a complete assessment by a psychiatrist and inpatient admission for patients identified as high risk (Level 4 or 5). Patients at low to moderate risk should be reassessed by a trained clinician and may not require admission.