Asking people about their thoughts and behaviors to identify their risk for suicide is the first, critical step in suicide prevention. Anyone, anywhere, can do that with the questions provided in the Columbia Protocol, also known as the Columbia-Suicide Severity Rating Scale (C-SSRS).

Families, Friends, and Neighbors

  • Columbia Protocol askers include family members, friends, colleagues, support group members, community leaders, homeless shelter workers, faith-based group leaders and members, and anyone else who may be in a position to ask.
  • Askers identify the risk of their family members, friends, colleagues, and acquaintances.
  • Askers conduct screening at home and in other private and familiar settings.

First responders

  • Columbia Protocol askers include law enforcement officers, firefighters, EMTs, paramedics, and the agency counselors who screen these first responders.
  • Askers identify risk among first responders themselves as well as the people they serve.
  • Askers conduct screening of first responders in private offices and of the public when out on calls or under first responder supervision or care.


  • Columbia Protocol askers identify risk among clients of government health and social service agencies.
  • National, state, and local governments use law and policy to mandate or encourage suicide risk identification in government and nongovernment settings, such as schools, health centers, hospitals, and police departments.
  • Policymakers incorporate the Columbia Protocol into national and state suicide prevention strategies.


  • Columbia Protocol askers include doctors, nurses, physician assistants, mental health counselors, and other healthcare staff, such as technicians, pharmacists, and facility personnel, who interact with patients and families.
  • Askers screen patients.
  • Askers conduct screening in hospitals, doctors’ offices, and clinics and at counseling centers, behavioral healthcare facilities, addiction centers, and caregiver services locations.


  • Columbia Protocol askers include medical staff, chaplains, mental health counselors, financial counselors, attorneys, service members, and veterans.
  • Askers screen service members and veterans.
  • Askers conduct screening through private interactions and systematically at VA hospitals and clinics, military medical care facilities, behavioral health programs, substance abuse programs, and sexual assault services locations.


  • Columbia Protocol askers include counselors, nurses, teachers, coaches, resident assistants, social workers, and students.
  • Askers screen students.
  • Askers conduct screening in elementary schools, middle schools, high schools, and colleges.


  • Columbia Protocol askers include correctional, medical, and mental health personnel.
  • Askers screen inmates and correctional officers.
  • Askers conduct screening in jails, prisons, juvenile detention centers, and other correctional facilities.


  • Columbia Protocol askers can include anyone designated by the researcher, as long as the askers view the Columbia Protocol training and receive a training certificate.
  • Askers screen patients in clinical trials to comply with requirements to assess a drug’s impact on suicidality.
  • Askers screen subjects in academic research to learn more about suicide risk and prevention.