C SSRS Clinical Practice Screener Since Last Visit 2017

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COLUMBIA-SUICIDE SEVERITY RATING SCALE

Screening Version – Since Last Visit


Since Last
SUICIDE IDEATION DEFINITIONS AND PROMPTS
Visit
Ask questions that are bold and underlined YES NO
Ask Questions 1 and 2
1) Wish to be Dead:
Person endorses thoughts about a wish to be dead or not alive anymore, or wish to fall
asleep and not wake up.
Have you wished you were dead or wished you could go to sleep and not wake
up?
2) Suicidal Thoughts:
General non-specific thoughts of wanting to end one’s life/die by suicide, “I’ve thought
about killing myself” without general thoughts of ways to kill oneself/associated methods,
intent, or plan.
Have you actually had any thoughts of killing yourself?

If YES to 2, ask questions 3, 4, 5, and 6. If NO to 2, go directly to question 6


3) Suicidal Thoughts with Method (without Specific Plan or Intent to Act):
Person endorses thoughts of suicide and has thought of a least one method during the
assessment period. This is different than a specific plan with time, place or method details
worked out. “I thought about taking an overdose but I never made a specific plan as to
when where or how I would actually do it….and I would never go through with it.”
Have you been thinking about how you might do this?
4) Suicidal Intent (without Specific Plan):
Active suicidal thoughts of killing oneself and patient reports having some intent to act on
such thoughts, as opposed to “I have the thoughts but I definitely will not do anything
about them.”
Have you had these thoughts and had some intention of acting on them?
5) Suicide Intent with Specific Plan:
Thoughts of killing oneself with details of plan fully or partially worked out and person has
some intent to carry it out.
Have you started to work out or worked out the details of how to kill yourself
and do you intend to carry out this plan?
6) Suicide Behavior

Have you done anything, started to do anything, or prepared to do anything to


end your life?
Examples: Collected pills, obtained a gun, gave away valuables, wrote a will or suicide note,
took out pills but didn’t swallow any, held a gun but changed your mind or it was grabbed
from your hand, went to the roof but didn’t jump; or actually took pills, tried to shoot
yourself, cut yourself, tried to hang yourself, etc.

Low Risk
Moderate Risk
High Risk

For inquiries and training information contact: Kelly Posner, Ph.D.


New York State Psychiatric Institute, 1051 Riverside Drive, New York, New York, 10032; posnerk@nyspi.columbia.edu
© 2008 The Research Foundation for Mental Hygiene, Inc.

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