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Columbia - Suicide Severity Rating Scale (C-SSRS) Screener Version
Please visit this website for more information about the instrument: Columbia - Suicide Severity Rating Scale Screener Version
Supplemental - Highly Recommended: Parkinson's Disease (PD)
Recommendations for use: The C-SSRS Screener Version is indicated for use as a safety measure to screen for and assess recent suicidal ideation and recent and lifetime suicidal behaviors in clinical research participants. The full C-SSRS is indicated for research involving data analyses on suicidal ideation and behavior.
Short Description of Instrument
The Columbia - Suicide Severity Rating Scale (C-SSRS) Screener Version (C-SSRS-Screener-recent-with-triage-colors-2021.docx (, a shortened version of the full C-SSRS, is a simple, efficient, and widely-used tool to identify individuals with suicidal ideation and behaviors who warrant a higher level of care. The C-SSRS Screener is used in research, clinical, and non-clinical settings, such as public schools, faith communities, the military, or law enforcement, and is available in over 100 languages.
The Columbia - Suicide Severity Rating Scale (C-SSRS) was designed to provide a prospective, standardized measure of suicidality through a series of simple, plain-language questions. The C-SSRS Screener Version contains a total of 6 possible yes or no questions that assess recent suicidal ideation over the last month and lifetime and recent suicidal behavior. The number and choice of questions are contingent on the answers received. Results triage respondents into low, moderate, and high-risk categories.
To monitor for suicidal ideation and behavior prospectively in clinical studies, the CSSR-S Screener Version can be conducted at the first visit to establish a baseline. The CSSR-S 'Since Last Visit' Version can be used for subsequent assessments (C-SSRS-Clinical-Practice-Screener-since-last-visit-2021.docx ( The full C-SSRS is conducted if the screening questions about suicidal ideation and behavior are positive.
Comments/Special Instructions
The Food and Drug Administration (FDA) regards the C-SSRS as the gold standard for assessing suicidal ideation and behavior in clinical trials. To that end, the C-SSRS Screener Version is suitable and recommended for prospective assessments of suicidal ideation and behavior in clinical trials of interventions with effects on central nervous system activity, including drugs for psychiatric and neurologic indications.
Scoring and Psychometric Properties
The C-SSRS response categories are binary (yes/no). A positive C-SSRS Screener score is a 'Yes' response to items 3, 4, 5, or 6. A positive C-SSRS Screener indicates a need for completion of the full C-SSRS and specialized mental health care. When the answer to items 4, 5, or 6 is 'Yes', immediate clinical mental health consultation and patient safety precautions are indicated.
Strengths: The C-SSRS Screener tool is a standardized, brief, and easy-to-administer tool that assesses suicide risk and can be used in clinical trials. The tool does not require special training or permission, making it suitable for use in community and non-mental health clinical settings. Training in administration of the full C-SSRS is recommended, but not required, for academic research (Training for Researchers The Columbia Lighthouse Project). Use of the C-SSRS in industry-funded research follows separate guidelines.
Weaknesses: Unlike the full C-SSRS, the Screener Version does not delineate specific types of suicidal ideation or behavior or generate separate scores for suicidal ideation or behaviors. To date, no Parkinson's disease studies, including clinical trials, report use of the C-SSRS Screener Version or 'Since Last Visit' Screener Version.
Key References:
Belvisi D, Berardelli I, Ferrazzano G, Costanzo M, Corigliano V, Fabbrini G, Berardelli A, Pompili M. The clinical correlates of suicidal ideation in Parkinson's disease. Parkinsonism Relat Disord. 2019 Jun;63:54-59.
Berardelli I, Belvisi D, Corigliano V, Costanzo M, Innamorati M, Fabbrini G, Berardelli A, Pompili M. Suicidal ideation, perceived disability, hopelessness and affective temperaments in patients affected by Parkinson's disease. Int J Clin Pract. 2018 Oct 19:e13287.
Berardelli I, Belvisi D, Nardella A, Falcone G, Lamis DA, Fabbrini G, Berardelli A, Girardi P, Pompili M. Suicide in Parkinson's Disease: A Systematic Review. CNS Neurol Disord Drug Targets. 2019;18(6):466-477.
Elfil M, Ahmed N, Alapati A, Bahekar R, Kandil M, Kim C, Schaefer S, Tinaz S, Patel AS, de Figueiredo JM, Louis ED, Koo BB. Suicidal risk and demoralization in Parkinson disease. J Neurol. 2020 Apr;267(4):966-974.
Greist JH, Mundt JC, Gwaltney CJ, Jefferson JW, Posner K. Predictive Value of Baseline Electronic Columbia-Suicide Severity Rating Scale (eC-SSRS) Assessments for Identifying Risk of Prospective Reports of Suicidal Behavior During Research Participation. Innov Clin Neurosci. 2014 Sep;11(9-10):23-31.
ISCTM SUICIDAL IDEATION AND BEHAVIOR ASSESSMENT WORKGROUP:, Chappell PB, Mahableshwarkar AR, Alphs LD, Bangs ME, Butler A, DuBrava SJ, Greist JH, Lenderking WR, Mundt JC, Stewart M. Prospective assessment of suicidal ideation and behavior: an internet survey of pharmaceutical sponsor practices. Innov Clin Neurosci. 2014 Sep;11(9-10):14-22.
US Food and Drug Administration. Suicidal Ideation and Behavior: Prospective Assessment of Occurrence in Clinical Trials. Rockville, MD: US Department of Health and Human Services; 2012.
Additional References:
Chang BP, Tan TM. Suicide screening tools and their association with near-term adverse events in the ED. Am J Emerg Med. 2015 Nov;33(11):1680-3.
Imran JB, Richmond RE, Madni TD, Roaten K, Clark AT, Huang EY, Mokdad AA, Taveras LR, Abdelfattah KR, Cripps MW, Eastman AL. Determining suicide risk in trauma patients using a universal screening program. J Trauma Acute Care Surg. 2018 Jul;85(1):182-186.
Katz I, Barry CN, Cooper SA, Kasprow WJ, Hoff RA. Use of the Columbia-Suicide Severity Rating Scale (C-SSRS) in a large sample of Veterans receiving mental health services in the Veterans Health Administration. Suicide Life Threat Behav. 2020 Feb;50(1):111-121.
Keaton SA, Madaj ZB, Heilman P, Smart L, Grit J, Gibbons R, Postolache TT, Roaten K, Achtyes ED, Brundin L. An inflammatory profile linked to increased suicide risk. J Affect Disord. 2019 Mar 15;247:57-65.
Omolewa, P., & Tribble, K. L. The Impact of C-SSRS (Columbia-Suicidal Severity Rating Scale) Usage on Quality of Care in John George Psychiatric Hospital (San Leandro, CA): a Medical Care Evaluation Study.
Roaten K, Johnson C, Genzel R, Khan F, North CS. Development and Implementation of a Universal Suicide Risk Screening Program in a Safety-Net Hospital System. Jt Comm J Qual Patient Saf. 2018 Jan;44(1):4-11.
Wilson, N. J. The Columbia-Suicide Severity Rating Scale: Validation for use as a screen for suicide risk in New Zealand prisons and probation settings. The New Zealand Corrections Journal; 2017. Vol. 5 Issue 2.
Document last updated August 2022