The latest suicide checklist to determine a person's risk of committing suicide might be better than other such methods at spotting people in the most urgent need of help, researchers report, according to HealthDay.
The Columbia-Suicide Severity Rating Scale (C-SSRS) was developed eight years ago and is already used by clinicians, emergency responders and others. A new study appearing in the American Journal of Psychiatry backs its use with new evidence.
One of three studies evaluating the C-SSRS involved 124 adolescents who had attempted suicide and another involved 237 adults who went to a hospital emergency department for psychiatric reasons. The third study evaluated the effectiveness of a medication for 312 depressed adolescents.
The researchers who created the C-SSRS weighed its scientific validity against the Columbia Suicide History Form, on which the newer scale builds, and the Beck Scale for Suicide Ideation, which is considered the gold standard of assessment tools, Kelly Posner, study author and director of the Center for Suicide Risk Assessment at Columbia University, said, according to HealthDay.
A big difference, Posner added, is that the C-SSRS measures a wider range of potentially suicidal behaviors. "In the past, people would [only] have asked about suicide attempts," Posner told HealthDay, adding that "the scale identified a range of behaviors —preparatory behaviors — writing a will, buying a gun. Now we're getting at these things. [A person] with just one behavior is eight to 10 times more likely to end their life."
"Suicidal ideation" means talking or thinking about killing yourself. The scale has five degrees of ideation, ranging from "wish to be dead" to "active suicidal ideation with specific plan and intent." "The Beck scale only looks at ideation and the Columbia History only looks at behavior," while the newer scale rates both, Posner explained to HealthDay. "It more clearly delineates the types of thoughts we need to get at."
Assessing suicide risk should be part of any routine medical visit, Posner continued. "I believe it should be, with 50 percent of people [who commit suicide] seeing their primary care physician within the month before they die," she said. "It's a public health crisis, but a preventable public health crisis. We need to do better at screening and identifying."
The test is easy to incorporate into routine medical visits, Posner told HealthDay. "Not only does it take just one or two minutes to administer, the screening version can be a few questions. It reduces false positives and it's less burdensome than not doing anything at all, when you're asking the correct questions."
Posner also noted that Health Canada, the New York City fire department and public school system, the Baltimore police department, the U.S. National Guard and the Israeli Defense Forces have sought training in using the C-SSRS or have already implemented it.
"I get calls from judges hearing cases. They're using it to reduce unnecessary hospitalizations and interventions — the same way schools are using it to redirect limited resources where they need to go," she told HealthDay.
"Some people aren't going to tell you, no matter what you ask," Posner told HealthDay. But, "a majority of people when asked will be forthcoming and will tell -- the point is [with C-SSRS] we're better identifying those who will and are at greatest risk."
The new study appears online in the American Journal of Psychiatry
