Collaborative Assessment and Management of Suicidality at Menninger (CAMS-M): An inpatient adaptation and implementation

The Menninger Clinic, 12301 Main St., Houston, TX, 77035, USA.
Bulletin of the Menninger Clinic (Impact Factor: 0.72). 06/2012; 76(2):147-71. DOI: 10.1521/bumc.2012.76.2.147
Source: PubMed


In this article, the authors describe CAMS-M, a novel approach to working therapeutically with suicidal psychiatric inpatients, with the goal of reducing the likelihood of future suicidal crises. CAMS-M, developed at The Menninger Clinic, is an adaptation of the Collaborative Assessment and Management of Suicidality (CAMS), a novel framework with promising early research findings in outpatient settings (Jobes, 2006). Here, we provide a detailed description of CAMS-M, describe how it differs from CAMS in its original form, and discuss issues around implementation in a hospital setting. We conclude that CAMS-M holds considerable promise in risk management and therapeutic intervention with suicidal patients in the inpatient environment.

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    • "When three consecutive CAMS sessions take place where suicidal coping has been eliminated, the suicide risk tracking process ends. The CAMS approach has demonstrated reduced distress and suicidal ideation during treatment (Jobes, Jacoby, Cimbolic, & Hustead, 1997), in outpatient settings (Jobes et al., 2005), psychiatric inpatient settings (Ellis, Daza, & Allen, 2012) and importantly was significantly correlated with reduced emergency department visits compared to treatment as usual. Two well-powered randomised controlled trials (RCTs) are currently being conducted to explore further if the CAMS reduces suicidal behaviour. "
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    ABSTRACT: Patients hospitalized for psychiatric reasons exhibit significantly elevated risk of suicide, yet the research literature contains very few outcome studies of interventions designed for suicidal inpatients. This pilot study examined the inpatient feasibility and effectiveness of The Collaborative Assessment and Management of Suicidality (CAMS), a structured evidence-based method for risk assessment and treatment planning (Jobes, 2006). The study used an open-trial, case-focused design to assess an inpatient adaptation of CAMS, spread over a period averaging 51 days. The intervention was provided via individual therapy to a convenience sample of 20 patients (16 females and four males, average age 36.9) who were hospitalized with recent histories of suicidal ideation and behavior. Results showed statistically and clinically significant reductions in depression, hopelessness, suicide cognitions, and suicidal ideation, as well as improvement on factors considered "drivers" of suicidality. Treatment effect sizes were in the large range (Cohen's d > .80) across several outcome measures, including suicidal ideation. Although these findings must be considered preliminary due to the lack of a randomized control group, they merit attention from clinicians working with patients at risk for suicide. This study also supports the feasibility of implementing a structured, suicide-specific intervention for at-risk patients in inpatient settings.
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