The Basics & Clinical Application
You skip to the behavior question if the client answers this to question 2.
What is No?
This is considered the lowest level of ideation: wishing you were dead or not waking up.
What is passive ideation?
This includes actions like collecting pills or writing a suicide note.
What are preparatory behaviors?
If a client only endorses passive wish to be dead, the risk is typically this.
What is low risk?
A client endorses passive wish to be dead only. Appropriate next step includes monitoring and this.
What is supportive follow-up or safety check-ins?
These two questions are always asked first in the screener
What are wish to be dead and actual thoughts of killing oneself?
Thinking about suicide without a specific plan or method falls under this category.
What is non-specific active ideation?
An attempt stopped by another person is called this.
What is an interrupted attempt?
Endorsing thoughts with a method usually indicates this level.
What is moderate risk?
This should be completed whenever any level of risk is identified.
What is a safety plan?
True or False: The C‑SSRS is a diagnostic tool
What is False? (It is a screening tool.)
When someone has thought about how they would kill themselves but no intent, this level is reached.
What is ideation with method (no plan or intent)?
Stopping oneself before completing an attempt is called this.
What is an aborted attempt?
Endorsing intent, plan, or recent behavior indicates this level.
What is high risk?
Client endorses intent to act but no specific plan. Immediate priority intervention?
What is safety planning with urgent evaluation and increased supervision?
This timeframe is typically assessed for ideation in the screener version.
What is the past month?
Having intent to act but no specific plan indicates this severity.
What is suicidal intent without plan?
This is the single strongest predictor of future suicide risk.
What is a prior suicide attempt?
The score and risk level are determined by this.
What is the highest endorsed item?
Client reports a suicide attempt within the past 3 months with "yes" to multiple questions. Required response?
What is immediate high-risk intervention (possible hospitalization, 1:1 observation, urgent evaluation, staffing with CSOC)?
This score or higher should result in a call to CSOC
What is a 3
This is the highest ideation level before behavior is considered.
What is plan with intent?
In triage, behavior within this timeframe significantly raises concern.
What is within the past 3 months?
rue or False: Any “yes” response requires at least some level of clinical follow-up.
What is True?
These responses automatically trigger highest level triage: intent, plan, OR this category of behavior.
What is recent suicidal behavior?