Suicide Prevention in Clinics & Hospitals

CAMS is a Therapeutic Framework for Suicidal Patients

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.

The Role of CAMS in Clinics and Hospital Systems of Care

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.