ALERT: Columbia Protocol Tools Are Appropriate for Use Over the Telephone or in Telemedicine

We know that the COVID-19 pandemic has made conducting studies and caring for the patients very difficult. To respond to the needs of the patients and research protocols and comply with the new guidelines on social distancing, prospective monitoring of suicide risk with the Columbia Suicide Severity Scale (C-SSRS) may proceed using alternative methods.

  • The C-SSRS can be administered over the phone or telemedicine platforms.
  • Users should determine whether they are subject to HIPAA (U.S.) or other health data privacy laws and use appropriate telemedicine/telecommunications tools.
  • Suicide risk may increase during the pandemic and researchers are advised to review their suicide risk management protocols.
  • As a general rule, patients who endorse thoughts with any intent to die (C-SSRS Severity of Ideation 4 or 5) in the past month or since last contact and/or those reporting any suicidal behaviors (preparatory behavior or interrupted/aborted/actual attempts) in the past 3 months or since last contact are at the highest risk and will require immediate in-depth clinical evaluation and follow up.
  • In addition to study-specific safety protocols, general public health resources exist to mitigate risk and are listed below.


  • The National Suicide Prevention Lifeline: 1-800-273-8255 (Deaf & Hard of Hearing Options:  1-800-799-4889)
  • The Crisis Text Line: text HOME to 741-741
  • The National Suicide Prevention Lifeline:  1-888-628-9454
  • The Veterans Crisis Line: 1-800-273-8255, followed by pressing 1.
  • The TrevorLifeline for LGBTQ youth: 1-866-488-7386
  • TrevorText: text TREVOR to 1-202-304-1200 (available M-F from 3PM to 10PM ET)
  • The Trans Lifeline: 1-877-565-8860