MIRECC / CoE

Recommendation Resources

Suicide risk screening is a key strategy for identifying patients at risk for suicide. It is recommended that validated tools be used for this purpose. Once risk is identified, health care providers can ensure that adequate assessment is conducted to facilitate appropriate risk management.

• Training/Clinical Resources
• Videos
• Webinars
• Articles

Training and Clinical Resources

This section includes recommended trainings and/or clinical resources about validated screening tools.

General Guidance and Tools

The Joint Commission Quick Safety Issue 68 Provides guidance on utilizing validated tools for suicide risk screening.

Columbia Suicide Severity Rating Scale Screener (C-SSRS Screener)

• The C-SSRS Screener is used to identify individuals at risk for suicide and is recommended for both the general population and populations at greater risk. Depending on the individual’s responses, either 3 or 6 items are administered.
• Free C-SSRS Training for Individuals and Systems
• C-SSRS Training for Researchers
• The U.S. Department of Veterans Affairs utilizes the C-SSRS Screener as part of its Suicide Risk Identification Strategy. Those with access can learn more on the VA Intranet.

Recommended Tools for the General Population

The Suicide Cognitions Scale-Revised (SCS-R) is a 16-item measure that assess thoughts, perceptions, and beliefs commonly experiences by who have attempted suicide.

• The scale can be used for suicide risk screening, assessment, or research purposes.
• Other versions and translations of the SCS are also available

The Patient Health Questionnaire 9 (PHQ-9) PHQ-9 is a 9-item measure used to assess symptoms of depression; the last item on the scale specifically inquires about suicidal thoughts.

Recommended Tools for Populations at Greater Risk

The Beck Suicide Intent Scale (BSIS) is a 20-item scale intended to assess the intensity of one’s desire to die at the time of a previous suicide attempt.

The Beck Scale for Suicidal Ideation (BSS) consists of 21 items which measure suicidal ideation and behavior; the first five items of the BSS can be used to screen for suicide risk.

Videos

This section includes recommended videos about validated screening tools to identify patients at risk for suicide-related behaviors.

Columbia-Suicide Severity Rating Scale Administration Training

Patient Health Questionnaire-9 Demonstration Video

Webinars

This section includes recommended webinars about validated screening tools to identify patients at risk for suicide-related behaviors.

Evidence-Based Practice in Suicide Risk Screening and Evaluation: Why, What, How and When? Presented by Dr. Nazanin Bahraini

Articles

This section includes recommended articles about using validated screening tools to identify patients at risk for suicide-related behaviors.

Bjureberg, J., Dahlin, M., Carlborg, A., Edberg, H., Haglund, A., & Runeson, B. (2021). Columbia-Suicide Severity Rating Scale Screen Version: initial screening for suicide risk in a psychiatric emergency department. Psychological medicine, 52(16). 1–9. https://doi.org/10.1017/S0033291721000751

Bryan, C. J., Thomsen, C. J., Bryan, A. O., Baker, J. C., May, A. M., & Allen, M. H. (2022). Scores on the suicide cognitions scale-revised (SCS-R) predict future suicide attempts among primary care patients denying suicide ideation and prior attempts. Journal of affective disorders, 313. 21–26. https://doi.org/10.1016/j.jad.2022.06.070

Harriss, L., & Hawton, K. (2005). Suicidal intent in deliberate self-harm and the risk of suicide: the predictive power of the Suicide Intent Scale. Journal of affective disorders, 86(2-3). 225–233. https://doi.org/10.1016/j.jad.2005.02.009

Lindh, Å. U., Dahlin, M., Beckman, K., Strömsten, L., Jokinen, J., Wiktorsson, S., Renberg, E. S., Waern, M., & Runeson, B. (2019). A Comparison of Suicide Risk Scales in Predicting Repeat Suicide Attempt and Suicide: A Clinical Cohort Study. The Journal of clinical psychiatry, 80(6). 18m12707. https://doi.org/10.4088/JCP.18m12707.

Podlogar, M. C., Gutierrez, P. M., & Osman, A. (2023). Optimizing the Beck Scale for Suicide Ideation: An Item Response Theory Approach Among U. . Military Personnel. Assessment, 30(4). 1321–1333. https://doi.org/10.1177/10731911221092420

Riblet, N. B., Matsunaga, S., Lee, Y., Young-Xu, Y., Shiner, B., Schnurr, P. P., Levis, M., & Watts, B. V. (2022). Tools to Detect Risk of Death by Suicide: A Systematic Review and Meta-Analysis. The Journal of clinical psychiatry, 84(1). 21r14385. https://doi.org/10.4088/JCP.21r14385

Rudd, M. D., & Bryan, C. J. (2021). The Brief Suicide Cognitions Scale: Development and Clinical Application. Frontiers in psychiatry, 12. 737393. https://doi.org/10.3389/fpsyt.2021.737393

Simon, G. E., Rutter, C. M., Peterson, D., Oliver, M., Whiteside, U., Operskalski, B., & Ludman, E. J. (2013). Does response on the PHQ-9 Depression Questionnaire predict subsequent suicide attempt or suicide death?. Psychiatric services (Washington, D.C.). 64(12), 1195–1202. https://doi.org/10.1176/appi.ps.201200587

Simpson, S. A., Goans, C., Loh, R., Ryall, K., Middleton, M. C. A., & Dalton, A. (2021). Suicidal ideation is insensitive to suicide risk after emergency department discharge: Performance characteristics of the Columbia-Suicide Severity Rating Scale Screener. Academic emergency medicine: official journal of the Society for Academic Emergency Medicine, 28(6). 621–629. https://doi.org/10.1111/acem.14198