Youth suicides and suicide attempts have steadily increased over the last several years, meaning more teens are at risk now. Assessing the intensity of suicidal thoughts is essential for determining the appropriate level of care for teens. A suicidal ideation scale is one tool clinicians use. Learn more about these scales and how they guide treatment decisions for teens in crisis.
What Is a Suicidal Ideation Scale?
Suicidal ideation ranges from passive ideas about dying to active attempts at suicide. A suicidal ideation scale is a vital screening tool that assesses an individual’s risk of suicide. Clinicians use various versions of the scale to determine appropriate interventions based on the nature and intensity of the ideation level.
Examples of Scales and Questions
The Columbia Protocol, widely adopted by organizations like the CDC and WHO, is one of the most commonly used scales for its simplicity and efficiency. The scale uses just six questions to evaluate a person’s suicidal thoughts and behaviors.
- Have you wished you were dead or wished you could go to sleep and not wake up?
- Have you had any thoughts about killing yourself?
- Have you been thinking about how you might do this?
- Have you had some intention of acting on them?
- Have you planned (or have started to plan) the details of how to kill yourself? Did/do you intend to carry out this plan?
- Have you done anything, started to do anything, or prepared to do anything to end your life? If yes, was this within the past three months?
Clinicians may use other suicidal ideation scales or evaluation methods instead of, or in addition to, the Columbia Protocol. The Suicide Assessment Five-Step Evaluation and Triage (SAFE-T), the Modified Scale for Suicidal Ideation (MSSI), and the Beck Scale for Suicide Ideation (BSSI) may also be used for teen suicide risk assessments.
How Clinicians Use a Scale of Suicidal Ideation
Evaluation scales allow clinicians to identify a teen’s current thoughts and behaviors for an immediate and relevant response. Clinicians ask clear, direct questions when using suicidal ideation assessment tools. For example, when using the Columbia Protocol:
- Affirmative answers to questions 2 or 3 indicate that the person is at some risk and should seek mental healthcare or further evaluation.
- Affirmative answers to questions 4, 5, or 6 indicate that the person is at high risk and should receive immediate, emergency-level care.
Responses help professionals determine the next steps. In general, teens who have passive thoughts about suicide need monitoring and support. Teens with active suicidal thoughts or plans of suicide require more urgent care. Emergency services should always be contacted in crisis situations. Individuals can call, text, or chat with the National Suicide Lifeline by dialing 988.
Benefits of Ongoing Assessment
These assessments might not capture all aspects of a teen’s thoughts, as suicidal ideation can fluctuate and teens may struggle to express themselves. Clinicians build rapport with their patients and perform evaluations like this over time for a more comprehensive picture of a teen’s mental health.
When used as part of ongoing assessment, clinicians can track patterns over time—and escalate or otherwise adjust treatment protocols as necessary. If a teen’s risk level escalates, their care team can promptly offer higher levels of support. Conversely, if a teen’s suicidal ideation decreases over time, their care team can pinpoint and build upon effective treatment strategies.
Treating Suicidal Ideation at Muir Wood
Suicide screenings, including suicide scales, are cornerstone elements in assessing a teen’s mental health. Early assessment and regular monitoring allow a support team to develop effective treatment plans tailored to the teen’s current state and needs.
At Muir Wood, we evaluate teens upon intake and monitor their progress throughout their stay. We treat suicidal ideation and other mental health issues. Fill out our assessment form or call us at 866-705-0828 to learn how we can help your child.