## THE INSTRUMENT, BRIEFLY
The suicide risk screen is the C-SSRS Screener, administered electronically. Six questions, asked in a fixed order, with a branch in the middle.
Q1 and Q2 are asked of every student. They ask about wishing to be dead, and about thoughts of killing yourself, both within the past month.
If a student answers yes to Q2, they are asked Q3, Q4 and Q5 – about having a method in mind, about intention, and about having worked out a plan.
If a student answers no to Q2, they skip to Q6.
Q6 is asked of every student, whatever they said to Q2. It asks whether they have ever done anything, started to do anything, or prepared to do anything to end their life. If yes, it asks whether that was within the past three months.
That branch is the most important structural fact about the instrument, and it is the one most often got wrong. A student can answer no to Q2 and yes to Q6. Behaviour without current ideation is real, and a screen built to skip Q6 when Q2 is negative would miss it entirely. SAFER's autumn 2026 screening found two students by exactly this path, and both were High Risk.
## THE STRATIFICATION
The licensed C-SSRS Screener card carries triage points, colour coded. Three colours. SAFER's three bands are those three colours.
| Columbia triage point | Items | SAFER band |
|---|---|---|
| Yellow | Q1 wished dead · Q2 thoughts of killing yourself | Low |
| Orange | Q3 method in mind · Q6 behaviour, lifetime, over three months ago | Moderate |
| Red | Q4 intention · Q5 plan with intent · Q6 behaviour within three months | High |
That is the whole mapping. A school can hold the card beside the Dashboard and check it in under a minute, which is the point.
SAFER's bands are not a local interpretation of the instrument. They are the instrument's own stratification, with a response attached to each tier.
Why that matters more than it sounds
Most school screening programs define their own thresholds. The moment a program does that, every question about its bands becomes a question about the program's judgment rather than about a validated instrument.
SAFER's answer to "why is that student High Risk" is "because the instrument says so, here, on this card." The judgment SAFER adds is not where the lines fall. It is what happens on each side of them.
Where SAFER departs from the card, and why
Twice, and both are recorded rather than quiet.
The card's action box tells a reader that if the answer to Q4, Q5 or Q6 is yes, they should get immediate help – call 988, call 911, or go to an emergency room – and stay with the person until they can be evaluated.
SAFER does not send a student to an emergency room on a screening result. The card is written for a layperson in a community setting with no clinician available and no capacity to do anything else. A SAFER school has a trained safety planner the same day and a named consulting clinician reachable the same day, which is a higher standard of response than the card can assume. The equivalent of stay with them is the continuous supervision in Module 5.6.
The card's action box also does not distinguish the two Q6 columns, while its colour coding does. SAFER follows the colour coding: a behaviour more than three months ago is orange, not red.
Both departures are clinical judgments, not mappings. They should be reviewed by the school's consulting clinician before a first screening, and SAFER's position is reviewed by its own.
## THE FOUR BANDS ON THE DASHBOARD
The Dashboard shows four labels and the toolkit uses three bands. That is deliberate, and it is the same arrangement throughout SAFER: one value decides, another displays.
| Dashboard shows | Items | Band |
|---|---|---|
| 🟢 MINIMAL | Nothing endorsed | Low |
| 🟡 LOW RISK | Q1 or Q2 | Low |
| 🟠 MODERATE-HIGH (Past History) | Q3, or Q6 lifetime over three months | Moderate |
| 🔴 HIGH RISK (Current Intent/Plan/Recent) | Q4, Q5, or Q6 within three months | High |
The display label tells a queue owner why. Past History on a screen at nine in the morning means something different from Current Intent, and a person reading the board should not have to open another column to find out which.
Every count comes from the band, never from the label. Four values in a reported distribution cannot be compared against your own spring numbers or against another school's. The label is for reading. The band is for counting.
## WHAT EACH BAND TRIGGERS
Low
Nothing additional, and that is correct.
Not nothing. Every student who takes the screen sees 988 on the screen itself, before and after the questions. A Low Risk student has already been given the one thing SAFER can put in front of a whole building, and they were given it at the moment they were thinking about the question.
No individual contact, no group, no call home. A school that pulls Low Risk students out of class is a school that will not finish its High Risk students the same day, and the same-day standard is the one promise the model makes.
The two Low tiers exist because they are different students. 🟢 Minimal endorsed nothing. 🟡 Low endorsed Q1 or Q2 and is visible on the board. Neither is contacted, and only one of them is worth looking at again in the spring.
Moderate
Resource list · 988 · a Tier 2 group by depression and anxiety score · a suggested check-in at about one week · and a recommended individual conversation with a planner within the week.
Moderate is not a same-day promise. A school with capacity may choose to see a Moderate student sooner, and that is a local decision rather than a standard.
Every Moderate student carries a flag, because the band contains only two kinds of student:
| Flag | The student | Why it matters |
|---|---|---|
| METHOD IDENTIFIED | Endorsed Q3, has thought about how | A method in mind is not the same as a thought |
| PRIOR ATTEMPT | Endorsed Q6 lifetime, over three months ago | A prior suicide attempt is the single strongest predictor of a future attempt |
The individual conversation is recommended, not promised. A second guaranteed same-week lane costs planner hours most schools do not have. A promise SAFER cannot keep everywhere is worse than a recommendation it makes everywhere, and the same-day standard for High Risk stays absolute because nothing competes with it.
When a flag is raised, the school records whether that conversation happened, and if not, why.
A school that cannot do them has made a visible decision rather than a silent one. Twenty-eight flagged students, nine conversations, barrier recorded as planner capacity is a documented capacity gap, which is a fundable thing. See Module 10.3.
✓ Take Action. Count your Moderates before you plan your staffing, not after. In SAFER's autumn 2026 screening, twenty-eight of twenty-nine Moderate students carried the prior-attempt flag. The flag was not a corner of the band. It was almost all of it, and twenty-eight recommended conversations is a different planning problem from seven same-day ones. See Module 3.3.
High
Seen the same day. Within two hours. A safety plan built with them before they go home.
Not referred the same day. Not contacted the same day. Sat with, by a trained person, who finds out what is going on and builds the plan in the same meeting.
That is the floor and it does not move. See Module 5.3, Module 6.3 and Module 7.1.
Elevated Clinical Risk is not a band
ECR is a determination a trained person makes in the room, with the basis written down.
No screening instrument produces it. A form filled out at a computer in third period cannot tell you a student is at serious and imminent risk. It can tell you which items they endorsed.
ECR is not a different population from High Risk. It is the same students at their most acute, identified in the conversation rather than by the screen. See Module 5.6.
## THE C-SSRS SCORE IS NOT THE BAND EITHER
The Dashboard carries a C-SSRS Score column. It is a count of endorsed items, not a severity index, and it must not be used to rank students.
Two real examples from one screening week, both scoring 3:
| Student | Endorsed | Score | Band |
|---|---|---|---|
| One | Q1, Q2, Q6 lifetime | 3 | 🟠 Moderate |
| Two | Q1, Q2, Q4 | 3 | 🔴 High |
Same number. One goes into a group. One is sat with inside two hours.
Sorting the board by C-SSRS Score produces the wrong order, in exactly the way sorting by depression score produces the wrong order. The score counts. The band decides. See Module 5.1.
This is the same lesson as Module 5.1, one layer further in, and it catches teams who have already learned the first version of it. A team that knows the PHQ-9A score is not the level will still, on a busy morning, reach for the column of numbers inside the C-SSRS.
## WHAT THIS LOOKS LIKE IN A REAL WEEK
From SAFER's autumn 2026 screening of 379 students in one building:
| Band | Students | Share |
|---|---|---|
| Low | 344 | 90.8% |
| Moderate | 28 | 7.4% |
| High | 7 | 1.8% |
Thirty-four students, nine percent of the building, reported lifetime suicidal behaviour on Q6. Thirty of those were more than three months ago.
That is the number that changes how a school thinks about Moderate. It is not a thin band of borderline cases. It is a group of students who have already, at some point, done something.
