Highest Columbia-Suicide Severity Rating Scale (C-SSRS) Screener Item Endorsed by Individuals Who Attempted Suicide...

The Columbia Suicide Severity Rating Scale (Posner et al.; C-SSRS) is a widely used measure, both in research and clinical practice, for the detection of suicide risk. The current study examines responses to the C-SSRS by individuals who attempted suicide in the 30 days before pre-trial jail detention.

Data were analyzed from the Suicide Prevention Intervention for at-Risk Individuals in Transition (SPIRIT) trial, which was conducted from May 2016 to November 2018 and included 800 individuals in pretrial jail detention with the primary inclusion criterion being endorsement of suicidal ideation with some intent to act (endorsement of C-SSRS C4 or C5) and/or a suicide attempt in the past month. This paper focuses on the first five screener items of the C-SSRS, which assess the highest level of suicidal ideation in the past month.

Most (65%) individuals who reported making a past 30-day suicide attempt indicated their highest level of suicidal ideation at the time of attempt was at the C4 (active suicidal ideation with some intent to act, without a specific plan), rather than the C5 level (active suicidal ideation with a specific plan and intent).

Fewer than one-third of individuals who had made at least one past 30-day suicide attempt in our sample had made specific plans. Findings highlight the unplanned nature of many suicide attempts and the risk for suicide among individuals without detailed suicide plans.

The SPIRIT (Suicide Prevention Intervention for at-Risk Individuals in Transition) trial is registered at clinicaltrials.gov (NCT02759172), Registered 3 May, 2016.