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Columbia Suicide Severity Rating Scale (C-SSRS)

The Columbia Suicide Severity Rating Scale (C-SSRS) is a clinical tool used to assess suicidal ideation and behavior. It helps professionals determine the severity of an individual’s suicidal thoughts and actions to evaluate and monitor suicide risk. Part A: Suicidal Ideation (Severity) Part B: Intensity of Ideation Part C: Suicidal Behaviour Part D: Lethality of […]


By Editorial Team | Editor Yamilla Francese
Clinically Reviewed by Lauren Barry, LMFT, MCAP, QS
Medically Reviewed by Ali Nikbakht, PsyD
Updated on March 3, 2026 — Editorial Policy | Research Policy | Privacy Policy
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The Columbia Suicide Severity Rating Scale (C-SSRS) is a clinical tool used to assess suicidal ideation and behavior. It helps professionals determine the severity of an individual’s suicidal thoughts and actions to evaluate and monitor suicide risk.

Part A: Suicidal Ideation (Severity)

  1. In the past month, have you wished you were dead?
    • a. Yes (1 point)
    • b. No (0 points)
  2. In the past month, have you had thoughts of killing yourself?
    • a. Yes (1 point)
    • b. No (0 points)
  3. In the past month, have you had the intention of acting on these thoughts?
    • a. Yes (1 point)
    • b. No (0 points)

Part B: Intensity of Ideation

  1. How often have you had these thoughts in the past month?
    • a. Several times a week (2 points)
    • b. Once a week (1 point)
    • c. Less than once a week (0 points)
  2. How long do these thoughts typically last?
    • a. All Day (2 points)
    • b. Hours (1 point)
    • c. Seconds (0 points)
  3. Can you control these thoughts, or do they happen whether you want them to or not?
    • a. Can’t Control (1 point)
    • b. Can Control (0 points)

Part C: Suicidal Behaviour

  1. Have you ever made a suicide attempt?
    • a. Yes (1 point)
    • b. No (0 points)
  2. Have you engaged in any self-harming behaviors without the intent to die?
    • a. Yes (1 point)
    • b. No (0 points)

Part D: Lethality of Suicide Attempt

  1. How much harm did you actually do to yourself during your most recent suicide attempt?
    • a. Severe physical harm (3 points)
    • b. Moderate physical harm (2 points)
    • c. Minimal physical harm (1 point)
    • d. Strongly Disagree (0 points)

Scoring and Results Interpretation

Score RangeInterpretation
0-3 pointsBehavior not likely to result in injury. Little or no indication of common Suicidal Ideation symptoms.
4-7 pointsBehavior likely to result in injury but not likely to cause death. Suggests a moderate indication of common Suicidal Ideation symptoms.
8-9 pointsStrong Indication of Suicide Ideation. Suggests a strong indication of experiencing symptoms common among those with Suicide Ideation.
10-13 pointsBehavior likely to result in death despite available medical care. Indicates a very strong correlation with severe Suicide Ideation symptoms.

Important Note: Interpretation of the C-SSRS involves considering responses in conjunction with clinical judgment. It does not produce a single numerical “grade,” but rather provides information to help mental health professionals determine the necessary level of care. This tool is not a substitute for a diagnosis from a healthcare professional.