The National Organization for Victim Assistance hosted a vital presentation on Suicide and the Impact of COVID-19. The panel focused on a number of important topics, including:

  • Understanding and using the Columbia Protocol
  • Means elimination and lowering the risk of suicide

The National Organization for Victim Assistance included a discussion led by faculty members from the Columbia University Department of Psychology.

Understanding the Columbia Protocol

The Columbia Protocol is a suicide risk assessment. The assessment is designed to be undertaken by anyone and not just mental health professionals. The Columbia Protocol risk assessment consists of a series of plain-language, simple questions. The answers to these questions are designed to identify:

  • Whether a person is at risk for suicide
  • The severity of that suicide risk
  • The immediacy of that risk
  • Level of support a person immediately needs

An example of the questions associated with the Columbia Protocol risk assessment is presented for your consideration. 

Columbia Protocol Question Card for Friends and Family

The Columbia Protocol includes a specific question card designed for use by friends and family who are concerned about a loved one feared to be contemplating suicide. The questions on the Columbia Protocol Question Card for Friends and Family are:

  1. Have you wished you were dead or wished you could go to sleep and not wake up?
  2. Have you actually had any thoughts about killing yourself?

If YES to 2, answer questions 3, 4, 5, and 6.
If NO to 2, go directly to question.Have you thought about how you might do this?

Have you had any intention of acting on these thoughts of killing yourself, as opposed to you have the thoughts but you definitely would not act on them?

  1. Have you thought about how you might do this?
  2. Have you had any intention of acting on these thoughts of killing yourself, as opposed to you have the thoughts but you definitely would not act on them?
  3. Have you started to work out or worked out the details of how to kill yourself? Do you intend to carry out this plan?

Always Ask Question 6

  1. Have you done anything, started to do anything, or prepared to do anything to end your life?

Examples: Collected pills, obtained a gun, gave away valuables, wrote a will or suicide note, held a gun but changed your mind, cut yourself, tried to hang yourself, and so forth. 

According to the Columbia Protocol, any “yes” response means that a person should seek assistance from a mental health professional. If a person provides a “yes” answer to question 4, 5, or 6, a person needs immediate help. The individual should be taken to the nearest emergency. You can also call (800) 273-8255 or 911. You can also text 741741 for assistance. You need to stay with an individual who answers these questions affirmatively until that individual is in appropriate professional care. 

Different Versions of the Columbia Protocol Question Card

Other Derivations of the Columbia Protocol Question Card are available. These cards are similar to the one delineated a moment ago. These Columbia Protocol Question Cards are:

Columbia Protocol Question Card for Spouses

Columbia Protocol Question Card for Teens

Columbia Protocol Question Card for Parents

These different derivations of the Columbia Protocol assessment questions are available at these links and can be downloaded.

Means Safety and Means Elimination to Lower the Risk of Death by Suicide

Mental health professionals are in a general consensus that in a majority of cases involving a person on the verge of taking his or her life by suicide there is at least some level of ambivalence. In other words, in advance of procuring the means to commit suicide, an individual will be ambivalent about making the final decision to end his or her life.

Because of this period of ambivalence, the issue of access to the means to end a person’s life becomes important. A study in the United Kingdom explains how access to a means for suicide and ambivalence relate to one another.

In the past, a notable number of people in the United Kingdom were taking their lives by ingesting large amounts of Tylenol. These individuals were easily opening bottles of Tylenol, took a deadly amount of the medication and ended their lives. 

Using the principle of making access to the means to commit suicide more difficult, a law was passed in the United Kingdom that Tylenol must be sold in blister packs. In other words, an individual has to spend time opening a blister packet containing one tablet.

In order for a person to access enough Tylenol tablets to take his or her life, that individual needs to spend what can amount to a considerable period of time opening blister packs to obtain enough of the medicine to comprise a fatal dose. In the aftermath of this packaging change, making using Tylenol as a means for suicide more difficult to come by, the number of suicides using Tylenol dropped to almost none in the United Kingdom. 


Emily Kil

Co-Owner of Eco Bear Biohazard Cleaning Company

Together with her husband, Emily Kil is co-owner of Eco Bear, a leading biohazard remediation company in Southern California. An experienced entrepreneur, Emily assisted in founding Eco Bear as a means of combining her business experience with her desire to provide assistance to people facing challenging circumstances. Emily regularly writes about her first-hand experiences providing services such as biohazard cleanup, suicide cleanup, crime scene cleanup, unattended death cleanup, infectious disease disinfection and other types of difficult remediations in homes and businesses.