Links To And Excerpts From “Calculated Decisions: Columbia-Suicide Severity Rating Scale (C-SSRS)”

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.

There are 82 similar articles in PubMed Central.

All that follows is from the above resource:


The Columbia-Suicide Severity Rating Scale (C-SSRS) screens for suicidal ideation and behavior.

Points & Pearls

  • 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 ().

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 (), and has been adopted by the Centers for Disease Control and Prevention to define and stratify suicidal ideation and behavior ().

When to Use

The C-SSRS should be used in patients in the emergency department for whom there is a concern for suicidality.

Next Steps

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.

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