Suicide Prevention in Clinics & Hospitals

CAMS is a proven therapeutic framework for suicidal patients

the role of CAMS in ClinicS and Hospital Systems of Care

In February 2016, the Joint Commission issued Sentinel Event Alert 56 Detecting and treating suicide ideation in all settings; CAMS was identified as an evidence based clinical approach that helps reduce suicidal thoughts and behaviors and was recommended as a method to improve outcomes for at-risk patients.

CAMS has been used extensively within outpatient and inpatient settings and as a brief intervention within psychiatric consultation-liaison services. Organizations using CAMS have opted to implement CAMS throughout their system of care from use by Crisis Response Teams and by Emergency Department providers to assess risk and determine disposition; to short-term interventions in Inpatient Units; to ongoing care in Intensive Outpatient Programs or standard Outpatient Treatment Clinics.  CAMS is designed to help the patient become the co-author of their treatment plan and take ownership of their progress. When CAMS is part of the system of care, it creates a shared language for each provider who encounters the patient and facilitates the patient’s progress towards resolution of the suicidal crisis.

The Suicide Status Form (SSF) has been used extensively in inpatient settings and we have published a series of papers about the psychometrics of the SSF (Conrad et al., 2009; Jobes et al., 1997; Jobes et al., 2009) as well as other related data pertaining to suicidal inpatients at the Mayo Clinic in Rochester MN.

Researchers at the Menninger Clinic have published a series of articles (Ellis Daza & Allen 2012) about an adapted inpatient use of CAMS at Menninger (referred to as “CAMS-M”). This team published a within-subjects open-trial case-focused design investigating the effectiveness of CAMS within a longer-term inpatient psychiatric stay (Ellis, Green, Allen, Jobes, & Nadorff 2012).

In a recent Menninger study there are robust and significant between-group changes (using “propensity score matching” to create a comparison control group) in overall suicide ideation and suicide-related cognitions (Ellis et al., 2015; Ellis et al., 2017).

There has been exploratory use of CAMS as a brief intervention within psychiatric consultation-liaison services. The focus of CAMS-BI is the completion of session that renders a CAMS Stabilization Plan and the identification of two problems that directly compel the patient to consider suicide (i.e., suicidal “drivers” within the CAMS model of care). The SSF provides an excellent HIPAA-compliant medical record progress note and can be used to further document clinical decision-making and dispositional next steps.

“The product works wonderfully to help persons with thoughts of suicide to organize and focus to complete the forms. We are experiencing very good reception to CAMS within our service area, for example, school districts, tribal behavioral health agencies, local behavioral agencies and others in private practice. We have provided workshops since 2015 and hope to continue being a resource provider in Northern Arizona.”



Why is CAMS the best choice for suicide prevention?
CAMS stands for the “Collaborative Assessment and Management of Suicidality” (CAMS). CAMS is first and foremost a clinical philosophy of care. It is a therapeutic framework for suicide-specific assessment and treatment of a patient’s suicidal risk. It is a flexible approach that can be used across theoretical orientations and disciplines for a wide range of suicidal patients across treatment settings and different treatment modalities.
Do you provide consultation on how to implement CAMS in an organization or hospital ?
Yes, senior CAMS-care consultants can provide “process improvement” consultation and guidance for successful implementation of CAMS in systems of care.  If you are interested in this option, please complete our inquiry form and someone from our team will contact you.
My organization is exploring implementing CAMS, could we arrange to have someone come and do a presentation?
Yes, CAMS-care does provide overview presentations of the model-which are not trainings of how to do CAMS.But we have seen certain organizations benefit from such presentations which may increase interest in being adherently trained in CAMS by expert CAMS-care consultants.
I am a child therapist, may I use CAMS with children?
Yes, adaptations of CAMS have been used with suicidal teens and children. There are preliminary data showing the promise of the CAMS and the SSF with suicidal teens and we are pursuing clinical trial research with these populations. The evidence base to date in support of CAMS is primarily based on adult samples but on-going and future research should help provide additional support for using CAMS with young people. It should be noted that working with suicidal children may require a slower pace and the use of breaks in the course of using CAMS. SSF constructs can be explained to children in an effort to create mutual understanding. Current research has shown the teens do not prefer a modified version of the SSF which means the clinician and patient can work together to come to shared understandings of CAMS-related terms.
Many of my patients have personality disorders, may I use CAMS with them?
From a research perspective, Dialectical Behavior Therapy (DBT for self harm) is undoubtedly the best proven intervention for personality disordered suicidal patients. Nevertheless, CAMS was equally effective to DBT for self harm in a recent Danish study in terms of decreasing suicide attempts and self-harm behaviors. In a sub-sample from this study 38% of borderline suicide attempters did extremely well at one year follow-up based only on 8-10 sessions of CAMS.

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