The single most common mistake, and the one the whole model turns on.
Two questions, two instruments
The numerical score tells you how many symptoms a student reports. The risk level tells you how dangerous the situation is.
They come from different instruments and they answer different questions.
Depression and anxiety scores come from the PHQ-9A and the GAD-7. They measure severity of symptoms over the past two weeks.
The risk level comes from the C-SSRS Screener. It measures suicide risk.
A student can be severe for depression and Low Risk for suicide. A student can score mildly on both and be High Risk because of a single item about a plan.
The two students
| Depression | Anxiety | C-SSRS | Risk level | |
|---|---|---|---|---|
| Student A | 13, moderate | 8, mild | Item endorsed | High |
| Student B | 24, severe | 9, mild | None | Low |
Most people, shown these two, worry more about Student B. Student B has a score nearly twice as high and is in considerably more distress.
Student A is the one you pull out of class in the next two hours.
Both things are true and saying so matters. Student B needs support. Student B is not at elevated risk of suicide today. Treating that as a contradiction is how teams end up either ignoring severe depression or panicking about it.
The rule
The level decides who is seen first. The score is context.
Context is not nothing. The score shapes what the conversation is about, what the referral should be, and which Tier 2 group makes sense. It just does not decide the queue.
✓ Take Action. Open your Dashboard and sort by depression score. Then sort by risk level. Watch the order change completely. Do this before screening day, with your whole team watching, because a team that discovers it on the day will hesitate.
Critical Reflection. In your building right now, if a counsellor had two students and one hour, which one would they see? What decides that, and is the thing that decides it written down anywhere?
