How can non-suicidal self-injurious behaviors be differentiated from suicidal behaviors in C-SSRS?

The differentiation between non-suicidal self-injurious behaviors and suicidal behaviors in the Columbia – Suicide Severity Rating Scale (C-SSRS) hinges on the assessment of intent to end one's life. Non-suicidal self-injury (NSSI) typically occurs without the intention of causing death; rather, individuals may engage in these behaviors to cope with emotional distress or to express feelings they cannot verbalize.

In contrast, suicidal behaviors involve a clear intent to end one's life. Therefore, during a suicide risk assessment, the critical aspect is understanding the individual's motivations: are they attempting to alleviate psychological pain or are they expressing a desire to die? This distinction is vital for determining the appropriate level of care and intervention necessary for the individual.

While frequency of behaviors, emotional responses, and their effects on physical health may provide additional context about the individual's situation, they do not accurately capture the fundamental difference in intent which is at the core of distinguishing between NSSI and suicidal behaviors. Understanding this intent is paramount for effective risk assessment and management in clinical practice.