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C-SSRS Screen

Columbia Suicide Severity Rating Scale — Screen Version

A free, validated screening tool for suicide risk and ideation severity. Your answers are scored in your browser — nothing is saved or transmitted.

About this tool

  • •The C-SSRS is the most-validated suicide risk assessment tool in clinical use — developed at Columbia University and adopted by the FDA, CDC, and major healthcare systems.
  • •The brief screen version uses 6 yes/no items to identify suicide risk across the spectrum from passive ideation to active behavior.
  • •ANY non-zero response indicates risk that warrants professional follow-up. This is a SCREENING tool — not a substitute for clinical evaluation by someone trained in suicide risk.
  • •The items are sequenced so that yes on later items (plan, intent, behavior) indicates higher risk than yes on earlier items (passive wish, ideation without plan).
  • •If you're experiencing any of the situations described, please contact a mental-health professional this week or call 988 if you're in immediate crisis. Help is available 24/7 and reaching out has been shown to reduce risk substantially.
  • •C-SSRS was developed by Posner et al (2011) at Columbia University Medical Center. It is in the public domain.

Take the C-SSRS Screen

These questions ask about thoughts and behaviors related to suicide. Please answer honestly — your responses are scored in your browser and not transmitted unless you choose to save them. If you're in crisis right now, please call or text 988 (Suicide and Crisis Lifeline) before completing this.

1.In the past month, have you wished you were dead or wished you could go to sleep and not wake up?
2.In the past month, have you actually had any thoughts of killing yourself?
3.In the past month, have you been thinking about how you might do this?
4.In the past month, have you had these thoughts and had some intention of acting on them?
5.In the past month, have you started to work out or worked out the details of how to kill yourself? Do you intend to carry out this plan?
6.Have you EVER done anything, started to do anything, or prepared to do anything to end your life?

0 of 6 answered

Your answers are processed in your browser. Nothing is saved or sent to anyone — including Tovani — until you choose to.

Frequently asked

I scored above zero. Does this mean I'm suicidal?

It means you have some thoughts or experiences along the suicide spectrum that warrant clinical attention. The spectrum is broad — passive wishes ("I wish I wouldn't wake up") are clinically meaningful but different from active plans. The clinician you reach out to will assess the specific picture. Any non-zero score warrants the conversation.

Will my score be reported to anyone?

No. Your responses are computed in your browser and not transmitted unless you explicitly choose to save them to your Tovani chart (with consent). The C-SSRS is not a mandatory-reporting tool — clinical reporting requirements (e.g., child welfare, involuntary commitment) require specific clinical determinations that this screen alone cannot make.

I had thoughts in the past but not now. Do I still need to talk to someone?

For current thoughts (items 1-5 ask about the past month), if you're below threshold currently, you don't have a clinical emergency. But item 6 (lifetime behavior) is significant — prior suicide attempts or preparations are clinically important context even when current state is stable. If you scored yes on item 6 and haven't talked with a clinician about it, that conversation is worth having.

Can ketamine help if I'm having suicide thoughts?

Yes — and this is one of the strongest indications for ketamine therapy in published evidence. Ketamine reduces suicidal ideation within hours of administration, much faster than SSRIs (4-6 weeks). For treatment-resistant depression with suicide thoughts, Spravato (esketamine) has specific FDA approval for this indication. Tovani screens carefully for suicide risk during eligibility consultation and adapts protocols accordingly — including more frequent check-ins during early treatment.

I don't want to call 988. What else can I do?

Several options if 988 doesn't feel right: (1) Text 988 instead of calling — same service, less pressure. (2) Chat at 988lifeline.org — text-based crisis support. (3) Contact your therapist or psychiatrist if you have one. (4) Tell ONE person you trust what's happening. (5) Go to your local emergency room. The goal isn't the specific channel; it's breaking the isolation that makes suicide thoughts most dangerous.

References

  1. Murrough JW et al. 2013, American Journal of Psychiatry. Ketamine RCT in treatment-resistant depression — rapid reduction in suicidal ideation alongside core depression response, often within hours of the first dose. PMID 23982301
  2. Sanacora G et al. 2017, JAMA Psychiatry. APA consensus on ketamine in mood disorders — explicitly addresses the rapid anti-suicide effect of ketamine and its clinical role in the suicidal-ideation indication. PMID 28249076

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