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C-SSRS (Since Last Visit Screen Version) - lacdmh lacounty

C-SSRS (Since Last Visit Screen Version) - lacdmh lacounty 2026

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The document outlines a structured assessment tool, the C-SSRS, for evaluating suicide ideation and behavior. It includes a series of questions designed to gauge an individual's thoughts and intentions regarding self-harm, ranging from general wishes to be dead to specific plans for suicide. The assessment progresses based on responses, allowing for a comprehensive understanding of the individual's mental state.

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Click ‘Get Form’ to open it in the editor.
Begin with Question 1, 'Wish to be Dead'. Select 'YES' or 'NO' based on the individual's feelings since the last visit.
Proceed to Question 2, 'Suicidal Thoughts'. If the answer is 'YES', continue to Questions 3 through 5. If 'NO', skip to Question 6.
For Question 3, assess if there are thoughts of suicide with a method but no specific plan. Mark accordingly.
In Question 4, determine if there is any intent behind those thoughts without a specific plan. Record the response.
Question 5 requires details about any specific plans for suicide. Ensure clarity in responses.
Finally, address Question 6 regarding any past behaviors related to suicidal actions. Document all relevant information.

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C-SSRS (Since Last Visit Screen Version) - lacdmh lacounty 2026

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