Collaborative Assessment and Management of Suicidality (CAMS): Feasibility trial for next-day appointment services

University of Washington, Seattle, Washington, USA.
Depression and Anxiety (Impact Factor: 4.41). 11/2011; 28(11):963-72. DOI: 10.1002/da.20895
Source: PubMed


Despite the ubiquity of suicidality in behavioral health settings, empirically supported interventions for suicidality are surprisingly rare. Given the importance of resolving suicidality and therapists' anxieties about treating suicidal patients, there is a clear need for innovative services and clinical approaches. The purpose of the current study was an attempt to address some of these needs by examining the feasibility and use of a new intervention called the "Collaborative Assessment and Management of Suicidality" (CAMS) within a "Next-Day Appointment" (NDA) outpatient treatment setting.
As part of a larger feasibility study, n = 32 suicidal patients were randomly assigned to CAMS care versus Enhanced Care as Usual (E-CAU) in an outpatient crisis intervention setting attached to a safety net hospital. Intent to treat suicidal patients were seen and assessed before, during, and after treatment (with follow-up assessments conducted at 2, 4, 6, and 12 months).
The feasibility of using CAMS in the NDA setting was clear; both groups appeared to initially benefit from their respective treatments in terms of decreased suicidal ideation and overall symptom distress. Although patients rated both treatments favorably, the CAMS group had significantly higher satisfaction and better treatment retention than E-CAU. At 12 months post-treatment, CAMS patients showed significantly better and sustained reductions in suicidal ideation, overall symptom distress, and increased hope in comparison to E-CAU patients.
CAMS was both feasible in this NDA setting and effective in treating suicidal ideation, distress, and hopelessness (particularly at 12 months followup).

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    • "Specifically, psychiatrists, mental health nurses, psychologists, mental health social workers, and mental health counselors all receive the CAMS training either in-person or online (Marshall et al.). CAMS is a systematic assessment, intervention and tracking for suicidality, recommended for Veteran populations in systematic reviews (Bagley et al., 2010; Comtois et al., 2011; Ellis et al., 2012; Jobes, 2006; Jobes et al., 2011; York, Lamis, Pope, & Egede, 2013). If the outpatient provider has been trained in CAMS, CAMS can become part of the discharge plan for a Veteran with a PRF. "
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    ABSTRACT: In total, 75% of suicides reported to the Joint Commission as sentinel events since 1995, have occurred in psychiatric settings. Ensuring patient safety is one of the primary tasks of inpatient psychiatric units. A review of inpatient suicide-specific safety components, inclusive of incidence and risk; guidelines for evidence based care; environmental safety; suicide risk assessment; milieu observation and monitoring; psychotherapeutic interventions; and documentation is provided. The Veterans Health Administration (VA) has been recognized as an exemplar system in suicide prevention. A VA inpatient psychiatric unit is used to illustrate the operationalization of a culture of suicide-specific safety. We conclude by describing preliminary unit outcomes and acknowledging limitations of suicide-specific inpatient care and gaps in the current inpatient practices and research on psychotherapeutic interventions, observation, and monitoring.
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    • "Various studies over the past 20 years have established the assessment value of the SSF (e.g., Conrad et al., 2009; Jobes, Jacoby, Cimbolic, & Hustead, 1997). While the current study is not a treatment-outcome-focused study, it is important to note that use of CAMS and the SSF has extensive empirical support as an effective means of rapidly reducing suicidal ideation and overall symptom distress, while increasing hope and reasons for living (Comtois et al., 2011; Jobes, Kahn-Greene, Greene, & Goeke-Morey, 2009; Jobes, Wong, Conrad, Drozd, & Neal-Walden, 2005). Approximately 200 patients will be recruited from the inpatient psychiatry unit at the Robley Rex VAMC for the current study. "
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    • "There are now five published correlational studies supporting the feasibility and clinical value of CAMS and the SSF with suicidal outpatients (Arkov et al., 2008; Jobes et al., 1997; Jobes, Kahn-Greene, Greene, & Goeke-Morey, 2009; Jobes, Wong, Conrad, Drozd, & Neal-Walden, 2005; Nielsen et al., 2011). A recent randomized clinical trial of CAMS both replicates and extends previous correlational support of the approach (Comtois et al., 2011). In this study, CAMS led to rapid and sustained reductions in suicidal ideation and overall symptom distress while increasing reasons for living, optimism, and hope in comparison to treatment as usual. "
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