Columbia Suicide Severity Rating Scale (C-SSRS)
Standardised tool for assessing suicidal ideation and behaviour. Used in emergency, inpatient, and outpatient settings. Recommended by FDA for clinical trials and widely adopted globally.
Score interpretation
No suicidal ideation or behaviour reported.
→ Routine safety planning. Reassess at each visit.
Passive wish to be dead without active intent.
→ Safety planning; increase follow-up frequency; address underlying psychiatric illness.
Active suicidal thoughts without specific plan or intent.
→ Comprehensive psychiatric assessment; consider inpatient referral; restrict access to means; crisis plan.
Active ideation with intent and/or plan — imminent risk.
→ URGENT psychiatric assessment. Consider emergency admission. Crisis team activation. Remove access to means immediately.
Past or current suicidal behaviour reported — high risk.
→ Immediate psychiatric review. Emergency admission strongly recommended. Risk management plan with MDT.
Interpretation bands for the C-SSRS. Apply clinical judgement and local guidance.
References
- Posner K et al. The Columbia–Suicide Severity Rating Scale: initial validity and internal consistency findings from three multisite studies with adolescents and adults. Am J Psychiatry. 2011;168(12):1266-1277.
- FDA Guidance. Suicidality: Prospective Assessment of Occurrence in Clinical Trials. 2012.
Related
Curated clinical cross-links plus same-class fallbacks.
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- Self-Harm Presentation · NICE NG225 (2022)
- Capacity Assessment (Mental Capacity Act) · MCA 2005; Code of Practice
- Acute Psychosis Management · NICE CG178 2014
- Depression Management · NICE CG90 2022
- Lithium Therapy Monitoring · NICE CG185
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.