Risk Identification with the Columbia Protocol is directive enough that you have an immediate indication of level of risk and flexible enough that interventions can be modified using clinical judgment. This enables everyone from parents to psychiatrists to utilize it’s evidence based features.

The “score” is either Low, Moderate or High risk depending on where there are affirmative answers. The most worrisome answers are the same in all settings and are a recent (past month) “yes” to question 4 or 5 on ideation severity and/or any recent (past 3 months) behavior. Answers are color coded  for easy risk level identification. Here is a triage document that shows how some different types of programs are using these worrisome answers to guide clinical decision making (i.e. does the patient requires 1:1 observation or a Psychiatrist to consult). As you look to delineate high, moderate and low-risk levels, you should use the cut-offs described as your anchors and you may wish to adapt or draw elements for next steps from the care plans attached as next steps are specific to the environment and resources available.