A short suicide questionnaire used millions of times by jails, schools, hospitals, police and defense forces worldwide not only identifies suicidal thoughts and behavior, but also helps predict which people are likely to try ending their lives, researchers announced.
By asking a series of direct questions, beginning with: "Have you wished you were dead or wished you could go to sleep and not wake up?" followed by "Have you actually had any thoughts of killing yourself?" the Columbia-Suicide Severity Rating Scale (C-SSRS) ranks suicidal thoughts and plans on a 5-point scale, ranging from 1, the wish to die; through 5, having a plan and intent to commit suicide.
Researchers put the tool to the test in three groups of people vulnerable to suicide: 124 teenage suicide attempters in a treatment study; 312 depressed teens in a medication study; and 237 adults who visited hospital emergency rooms for psychiatric reasons. The results were analyzed by the tool's Columbia University developers, along with colleagues from several other institutions, who released their findings online Wednesday in the American Journal of Psychiatry.
Lead study author Kelly Posner, director of Columbia's suicide risk assessment program, said the idea behind the questionnaire was to improve suicide prevention by more precisely identifying those youngsters and adults at risk of ending their lives before they can carry out their plans.
"What this paper has done is give us prediction, which is a national priority for prevention," Posner told ABCNews.com. Study participants who had "worrisome answers" to the questions "were 50 percent more likely to attempt suicide," during the year they were followed, she said.
The suicide questionnaire assesses more than just whether someone had attempted suicide.
"In the past, people would only ask about a suicide attempt," Posner said. "You would miss the person who bought the gun yesterday or put the noose around their neck, (or the person) collecting or buying pills, writing a will or suicide note."
By more precisely identifying a range of suicidal thoughts and behaviors, the tool is finding "the people at risk we would have missed before," Posner said. The questionnaire also assesses "how much medical damage was there when they attempted suicide? Did they take two pills, or try to shoot themselves in the head? Were they in the hospital intensive care unit?" Posner said. All of that information "tells you something about the level of severity of risk."
"Having a proven method to assess suicide risk is a huge step forward in our efforts to save lives," said Dr. Michael Hogan, commissioner of the N.Y. State Office of Mental Health. He called the scientific validation of the rating scale "a critical step in putting this tool in the hands of health care providers and others in a position to take steps for safety."
Dr. Jeffrey Lieberman, psychiatry chairman at Columbia, noted the tool's potential to make a dent in the current volume of suicides.
"The public health benefits in terms of lives saved could be enormous," he said.