Suicide Safety Plan

Suicidal Ideation Across Long Term Care

Colorado Crisis Line dial 988

Risk assessment tool – Columbia suicide Severity Rating Scale (C-SSRS)

• Plan
• Means
• Intent
• Plan to act? When? Already started?
• Create a safety plan as though the person already has a plan.

Make sure to use the words “thinking of killing yourself” when you assess the patient.

Do not argue with a suicidal person and DO NOT try to convince them that they are fine.

• Lethality assessment
  • Low Risk – Passive SI without plan and no intent
    • q15 min checks, safety plan, regularly reassess risk, id coping skills
  • Medium Risk – active SI with a plan but NO intent or past attempts with current passive SI.
    • q15min checks,
    • remove access to the means of committing suicide,
    • 1:1 companion,
    • safety plan,
    • coping techniques,
  • High Risk – active SI with a plan AND intent or past attempt with active SI with or without plan/intent.
    • consider M1 Hold
      • Usually 72 hrs but the evaluating doctor can cut that short if clinically justified
      • Not to be used as a “just to be safe” measure

C-SSRS Screen Version