C-SSRS Basics
This C-SSRS question must be asked even when the individual denies actually thinking about killing themselves.
What is Question 1, Wish to Be Dead?
“I wish I could go to sleep and just not wake up.”
What is Wish to Be Dead, C-SSRS Item 1?
Occasional homicidal thoughts, angry verbal outbursts, and some urges to kill may indicate this risk level when there is no history of impulsive acts or homicidal attempts.
What is Level 2, Low Risk?
Alex describes a current highly lethal plan, has immediate access to the means, has a history of serious violence, and repeatedly states a strong desire to “get even.”
What is Level 5, Very High?
An individual endorses only C-SSRS Item 1. At minimum, discharge planning includes this level of referral plus crisis, safety, and aftercare planning.
What is an outpatient referral?
An individual says,“Sometimes I think about killing myself, but I haven't thought about how I would do it.” This corresponds to this C-SSRS item.
What is Question 2, Suicidal Thoughts?
“I've thought about killing myself.”
What is Suicidal Thoughts, Item 2?
A current high-lethality plan, available means, history of homicide attempts or impulsive acting out, and a strong urge to “get even” indicates this level.
What is Level 5, Very High Risk of Homicide?
Taylor identifies a specific person they want to kill, describes a plan, and has access to the means necessary to carry it out.
Answer: What is Level 4, High?
A Level 2 assault/homicidal danger rating calls for outpatient services, crisis information, and this important planning intervention.
What is developing, reviewing, or revising the safety/crisis plan?
When an individual answers NO to C-SSRS Question 2, the assessor goes directly here.
What is Question 6, Suicide Behavior?
“I've thought about killing myself, and sometimes I think I actually might do it, but I haven't developed a plan.”
What is Suicidal Intent without Specific Plan, Item 4? C-SSRS
A homicidal plan combined with obtainable means raises the assessment to at least this level.
What is Level 4, High Risk of Homicide?
Jordan denies wanting to hurt anyone, has no history of violence, identifies supportive family members, and reports no concerning substance use.
What is Level 1, None to Very Low?
For a Level 3 assault/homicidal risk, staff should address environmental safety and specifically provide this type of counseling.
What is lethal means counseling?
An individual says,“I've thought about overdosing, but I haven't planned when or where, and I don't intend to do it.”
What is Question 3, Suicidal Thoughts with Method without Specific Plan or Intent?
The individual denies current suicidal thoughts but reveals that two months ago they collected pills and intended to overdose before changing their mind.
What is Suicidal Behavior, Item 6, within the last three months? C-SSRS
The individual has no assaultive/homicidal ideation or history and has an adequate support system.
What is Level 1, No Predictable Risk?
Sam occasionally thinks about hurting a neighbor when angry. Sam has no plan, no history of attempts, and reports having supportive family available.
What is Level 2, Low?
An individual endorses C-SSRS Item 5. These crisis-care options are recommended, along with consultation.
What are Inpatient, FBC, Detox, or BHUC, with consultation with the Clinical Program Specialist or Clinical Coordinator?
An individual reports having worked out details of how they would die and acknowledges some intention of carrying out the plan.
What is Question 5, Suicide Intent with Specific Plan?
“I've thought about using pills, but I haven't decided when, where, or exactly how.”
What is Suicidal Thoughts with Method, Item 3?
Occasional homicidal thoughts, angry verbal outbursts, and some urges to kill may indicate this risk level when there is no history of impulsive acts or homicidal attempts.
What is Level 2, Low Risk?
Chris frequently thinks about killing an ex-partner but denies a specific plan. Chris has a history of impulsive aggression when intoxicated and reports worsening arguments with family.
What is Level 3, Moderate?
An individual is assessed at Level 4 or 5 on the Assault/Homicidal Danger Assessment. Name 2 of the 3 required clinical responses identified by the tool.
What are: