C-SSRS: Columbia Suicide Severity Rating Scale - Screener Version
The C-SSRS Screener is a validated 6-item safety screening tool that assesses suicidal ideation and behavior. Used worldwide in clinical, research, and community settings, it provides immediate risk classification with crisis resources.
Understanding the C-SSRS: Suicide Safety Screening
If you are in crisis right now, please call or text 988 (Suicide & Crisis Lifeline), text HOME to 741741 (Crisis Text Line), or call 911. You do not have to face this alone.
The Columbia Suicide Severity Rating Scale (C-SSRS) is the world's most widely used evidence-based tool for assessing suicidal ideation and behavior. Developed by Dr. Kelly Posner and colleagues at Columbia University, the C-SSRS has been adopted by the FDA, the VA, the Department of Defense, the World Health Organization, and hundreds of healthcare systems worldwide.
Why the C-SSRS matters: Suicide is the 10th leading cause of death in the United States and the 2nd leading cause among individuals aged 10-34. Many people experiencing suicidal thoughts do not disclose them unless directly asked. The C-SSRS provides a structured, compassionate way to ask the right questions and identify individuals who need help.
What this screener version measures: The C-SSRS Screener Version used here contains 6 questions that assess two dimensions:
- Suicidal Ideation (Questions 1-5): A progressive scale from passive wish for death (Q1) through active suicidal ideation with specific plan and intent (Q5). The highest level endorsed determines ideation severity.
- Suicidal Behavior (Question 6): Whether the person has ever attempted suicide or taken preparatory actions.
The progressive structure is clinically meaningful:
- Q1 — Passive ideation: Wish to be dead or not wake up
- Q2 — Non-specific active ideation: Thoughts of killing oneself
- Q3 — Active ideation with method: Thinking about how
- Q4 — Active ideation with intent: Some intention to act
- Q5 — Active ideation with plan and intent: Specific plan with intent to carry it out
- Q6 — Suicidal behavior: Any lifetime attempt or preparatory action
Validation and adoption: The C-SSRS has been validated in over 500 studies across diverse populations. It demonstrates strong predictive validity for suicide attempts and completions. It is available in over 140 countries and has been translated into more than 150 languages.
Critical disclaimer: The C-SSRS is a screening tool — it does not replace comprehensive clinical evaluation. Any positive response on this screener warrants immediate clinical follow-up. If you or someone you know is in danger, contact emergency services immediately.
Reference: This assessment is based on the Columbia Suicide Severity Rating Scale developed at Columbia University (Posner et al., 2011). The screener version is freely available for use.
Ready to Begin?
This assessment takes about 2-3 min to complete. Your responses are private, never stored, and you can instantly download your results as a PDF.
How to Take the C-SSRS Screener
Answer Questions
Complete the assessment honestly based on how you've been feeling
Get Your Score
Instant calculation using clinically validated scoring methods
Download PDF
Save or share your detailed results with your provider
Important: If you are currently in crisis or feeling unsafe, please stop and call 988, text HOME to 741741, or call 911 before proceeding.
You'll answer 6 yes/no questions about suicidal thoughts and behavior. Each question is answered Yes (1) or No (0).
The 6 questions assess:
Suicidal Ideation (Questions 1-5):
- Wish to be dead — Passive thoughts about wanting to be dead or not waking up
- Non-specific active thoughts — General thoughts of killing oneself
- Active ideation with methods — Thinking about how one might kill oneself
- Active ideation with intent — Having thoughts with some intention of acting
- Active ideation with plan and intent — Working out details with intent to carry out the plan
Suicidal Behavior (Question 6):
6. Lifetime behavior — Any past attempt, aborted attempt, or preparatory behavior
The questions progress from less severe to more severe ideation. This structure helps identify the highest level of suicidal thinking a person is experiencing.
This assessment takes 2-3 minutes. Answer each question honestly. Your responses are processed entirely in your browser and are never stored or transmitted.
After completing this screener: If any question is answered "Yes," crisis resources will be prominently displayed with your results. Please take them seriously and reach out for support.
C-SSRS Scoring and Risk Classification
Risk Classification:
The C-SSRS Screener does not produce a traditional "score" like other assessments. Instead, it classifies risk based on the highest level of ideation endorsed and whether suicidal behavior is present.
No Identified Risk (All "No" responses): No suicidal ideation or behavior was endorsed. This screening captures a single point in time. If thoughts of suicide arise in the future, reach out to a mental health professional or call 988 immediately.
Low Risk (Q1 or Q2 endorsed): Passive death wish or non-specific suicidal thoughts were reported. While these may not include a specific plan or intent, they are clinically significant and should be discussed with a mental health professional. Follow-up evaluation is recommended.
Moderate Risk (Q3 or Q4 endorsed): Active suicidal ideation — thinking about methods or having some intent to act — was reported. This requires clinical evaluation by a qualified mental health professional today. Please contact your provider or a crisis service.
High Risk (Q5 or Q6 endorsed): Active suicidal ideation with specific plan and intent, or past suicidal behavior, was reported. This requires immediate safety evaluation. Please contact 988, text HOME to 741741, or call 911 now. You do not have to face this alone.
Understanding ideation levels: The C-SSRS measures ideation on a 1-5 severity scale. Research shows that higher ideation levels are associated with increased risk of suicide attempts. However, any level of suicidal ideation is clinically important and warrants professional attention.
Suicidal behavior (Q6): A history of suicidal behavior is one of the strongest predictors of future attempts, regardless of current ideation level. If Q6 is endorsed, clinical evaluation is warranted even if no current ideation is reported.
Crisis resources:
- 988 Suicide & Crisis Lifeline: Call or text 988 (available 24/7)
- Crisis Text Line: Text HOME to 741741
- Emergency: Call 911 or go to your nearest emergency room
- Veterans Crisis Line: Call 988, then press 1
- Trevor Project (LGBTQ+ youth): Call 1-866-488-7386 or text START to 678-678
Frequently Asked Questions
Common questions about the C-SSRS assessment.
- The Columbia Suicide Severity Rating Scale (C-SSRS) was developed by Dr. Kelly Posner and colleagues at Columbia University, with funding from the National Institute of Mental Health. First published in 2011, it has become the global standard for suicide risk screening. The screener version used here is a brief 6-question form derived from the full C-SSRS clinical interview. It is used by the FDA, the VA, the Department of Defense, the CDC, and healthcare systems in over 140 countries.
- Any "Yes" answer on the C-SSRS indicates some level of suicidal ideation or behavior and warrants follow-up. A "Yes" to Q1 or Q2 suggests the need for a conversation with a mental health provider. A "Yes" to Q3, Q4, or Q5 indicates active ideation requiring more urgent clinical evaluation. A "Yes" to Q6 (past behavior) is a significant risk factor. **A positive screen is not a diagnosis** — it is a signal that professional assessment is needed.
- No. The C-SSRS is a universal screening tool designed to be administered broadly, including to people who may not appear to be at risk. Many people experiencing suicidal thoughts do not voluntarily disclose them. Routine screening with the C-SSRS helps identify individuals who need support but might otherwise go undetected. It is safe to ask these questions — research consistently shows that asking about suicide does not increase risk.
- No. This is a common myth that has been thoroughly debunked by research. Multiple studies have demonstrated that asking about suicidal thoughts and behaviors **does not increase suicidal ideation** and may actually reduce distress by providing an opportunity for disclosure. The C-SSRS was specifically designed to ask these questions in a structured, safe manner.
- Item 9 of the PHQ-9 asks a single question about "thoughts that you would be better off dead, or of hurting yourself." The C-SSRS is more comprehensive, distinguishing between passive ideation, active ideation, ideation with methods, ideation with intent, ideation with plan, and actual behavior. This granularity provides more clinically useful information for determining the appropriate level of intervention.
- Yes. After completing the screener, you can download your results as a professional PDF report including your risk classification, highest ideation level, clinical interpretation, and crisis resources. The PDF can be shared with your healthcare provider or crisis counselor. Given the sensitive nature of this assessment, we recommend discussing results with a professional.
- Yes. All assessment data is processed entirely in your browser — no information is transmitted to or stored on our servers. Your responses remain completely private, ensuring full privacy and HIPAA compliance for clinical use. This is especially important given the sensitive nature of suicide risk screening.
- In clinical settings, the C-SSRS is typically administered at every visit for patients with identified risk factors, and periodically for general populations. Many emergency departments and inpatient units administer it at admission and discharge. For self-monitoring, there is no specific recommended frequency — if you are experiencing thoughts of suicide at any time, please reach out for help immediately rather than waiting for a scheduled screening.
- Yes. The C-SSRS has been validated for use with adolescents and is widely used in pediatric settings, schools, and juvenile justice systems. Suicide is the second leading cause of death among individuals aged 10-24, making routine screening in this age group critically important. The questions are appropriate for ages 12 and older, with age-appropriate language adaptations available for younger children.
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