From Uniform Definitions to Prediction of Risk: The Columbia Suicide Severity Rating Scale Approach to Suicide Risk Assessment

Abstract

Suicide prevention is of high national and international importance as suicide remains one of the world’s greatest public health crises. Identification is the key to prevention, and therefore the ideal suicide risk assessment instrument enables identification of high risk individuals, monitors for suicide risk factors, and predicts future suicidal behavior in both research and practice. However, research and clinical practice have been challenged by nomenclature and methodological limitations regarding assessment of suicidal ideation and behavior. Systematic assessment for suicidal risk is feasible and provides more reliable outcomes, establishes operationalized criteria, and specifies parameters for triggering referrals, thereby decreasing unnecessary referral and burden. Therefore, assessment of suicidal ideation and behavior should be routinely integrated across public health settings. Knowledge of the full range of suicidal ideation and behaviors and key criteria for differentiating suicidal and non-suicidal events is paramount to the advancement of suicide risk assessment. The Columbia Suicide Severity Rating Scale (C-SSRS), a brief, standardized research-supported risk assessment tool, identifies individuals at increased risk for suicide to lower the overall disease burden and potentially the numbers of unnecessary deaths.