Where You Work: Children’s Hospitals

Kids Today: Thoughts From Research, Practice, and the Classroom

Drawing on over 35 years of suicide research, clinical practice, and the college classroom, Dr. Jobes – developer of the CAMS Framework® – offers a nuanced, evidence-informed perspective on today’s youth. Through the voices of young people themselves, the article challenges generational stereotypes and makes a compelling case for creating more space for young people to be heard, understood, and supported.

Read the full article: Kids Today: Thoughts From Research, Practice, and the Classroom

About the Author

David A. Jobes Ph.D. ABPP

David A. Jobes Ph.D. ABPP
David Jobes, PhD, ABPP, is the founder of CAMS-care, LLC. He began his career in 1987 in the Counseling Center of the Catholic University of America, where he developed a suicide risk assessment tool for college students that evolved into CAMS. Dr. Jobes is now a Professor of Psychology and Associate Director of Clinical Training at Catholic; he has trained thousands of mental health professionals in the United States and abroad in evidence-based assessment and treatment of suicide risk and the use of CAMS.

See More Articles by this Author

KVC Health Systems’ 6-Step Guide to Implementing CAMS with Private Funding

Date: February 18, 2026

KVC encourages ongoing training to support our teams in providing high-quality, evidence-based services to their clients.

 

“Nearly every person in this world has been touched by suicide in some way.”

Dr. Megan Moore sees this reality every day. As the Senior Director of Innovation and Impact with KVC Behavioral HealthCare Kentucky, a subsidiary of KVC Health Systems, she’s worked tirelessly alongside her 2,800 colleagues across 65 locations in five states to eradicate suicide, which takes about 50,000 lives in the U.S. each year.

Moore knew that achieving this ambitious goal wouldn’t be possible overnight. But by equipping clinicians with the competence and confidence to deliver timely, individualized care, including treating the drivers of each patient’s suicidal ideation, KVC could strengthen its approach to suicide prevention and save more lives.

In 2024, together with Chad Anderson, LSCSW, KVC’s Chief Clinical Officer based in Kansas, who brought deep clinical expertise and system-wide leadership, they integrated the evidence-based Collaborative Assessment and Management of Suicidality (CAMS) framework into their system of care. With an engaged cohort of leaders and clinicians, private philanthropic funding, and a collaborative partnership with CAMS-care, the KVC team moved from concept to implementation in just four months.

KVC’s early results of clinician engagement and patient outcomes are incredibly exciting. Their practical six-step approach offers a replicable blueprint for other mental health organizations with limited time and resources to similarly strengthen their suicide prevention practices and join us in advancing a world without suicide.

Connection as the Foundation for Saving Lives

At the heart of both KVC and CAMS is the shared belief that connection saves lives. Connection is what fosters health and healing. In suicide prevention, connection is especially critical, both in terms of a patient’s relation to family and community and ensuring a coordinated approach to services. When a person who is suicidal has access to timely, individualized, and connected care at the ideation stage, we can minimize the risk of ideation becoming behavior. Fewer attempts mean fewer deaths and lower health system costs.

At KVC, connection is ingrained across its entire system of care. Through their Safe and Connected™ practice model, they support families and communities with high-quality mental health and family-strengthening services spanning the continuum of care from in-home to inpatient treatment. Access to healthcare (both physical and mental) and community support is limited in rural areas. In the past two decades, suicide rates have increased 46% in non-metro areas (compared to 27.3% in metro areas). Many of KVC’s locations are in rural communities to meet this growing need for services, often providing in-home treatment and wraparound support, where access to services can be limited, and transportation is a barrier for those who need it most.

CAMS is an evidence-based, suicide-focused framework that operationalizes this approach to suicide prevention. Dr. Mariam Gregorian, CAMS Consultant, explains, “The CAMS Framework® is the most effective treatment for the largest population — the 16.9 million Americans who experience serious thoughts of suicide each year.” Through its collaborative, flexible process, clinicians and patients jointly identify and treat the personal drivers of suicidality as early as possible. It also serves as an umbrella framework that integrates seamlessly into existing models of care, strengthening what clinicians are already doing while aligning teams around a shared, proactive prevention strategy.

The natural synergy between KVC’s connection-first culture and CAMS’ focus on proactively and collaboratively treating suicidal drivers planted the seeds for change.

Discovering CAMS to Treat Suicidal Drivers

KVC’s first exposure to CAMS happened in the early 2000s. Megan Moore met Dr. Melinda Moore, CAMS Consultant, suicide loss survivor, and professor at Eastern Kentucky University, at a training hosted by her agency in Lexington, KY. What Megan Moore learned about CAMS changed the way she thought about suicide. She no longer saw suicide as a symptom of depression, but as the specific focus of care.

Moore and Anderson were curious to learn more about CAMS and its potential to strengthen KVC’s approach to suicide prevention. They also wanted to bring in other members of their clinical leadership team for their feedback. Through both virtual and in-person conversations, Gregorian helped them understand their options and their advantages in a systemic way.

After previewing some of the CAMS training products, the KVC team became determined to integrate CAMS as an evidence-based practice into their system of care. Because no two patients are alike and insurance policies vary by state, Anderson envisioned adding CAMS as another tool in clinicians’ toolkits. Anderson recalls, “We saw how CAMS saves lives. Why wouldn’t we invest in it?”

Implementing CAMS into KVC’s System of Care

Moore and Anderson approached this process with thoughtfulness and intentionality to minimize resources and maximize impact. Here are the six steps that took them from planning to implementation.

Step 1: Identify and Empower Champions

Every system-wide change needs a strong leader behind it. For KVC, that was Moore and Anderson. They’re both visionaries with a deep understanding of both clinical practice and implementation science. They built momentum, provided ongoing support and communication, and kept their teams informed and engaged from pilot toimplementation.

Step 2: Establish a Pilot Group

In January 2024, KVC launched a small, multidisciplinary pilot group. It consisted of approximately 32 clinicians and senior business leaders from its six subsidiaries: KVC Kansas, KVC Kentucky, KVC Missouri, KVC Nebraska, KVC West Virginia, and Camber Mental Health, KVC’s network of inpatient mental health hospitals and residential treatment centers.

Anderson describes, “We were all in it together.” Energy and engagement levels were high. The cohort established regular touch points and met consistently for 12 months. During this time, they received monthly consultation calls, peer support, and case review. Leadership actively participated alongside clinicians, ensuring they stayed in lock step throughout the process.

Step 3: Secure Funding

To begin the CAMS training process, KVC needed funding. Each of the six nonprofit subsidiaries operates independently, so each led respective efforts to secure funding. They focused their efforts on reaching out to existing networks, with support from their KVC Foundation team.

As a result of their outreach, an anonymous private funder awarded $25,000 to fund the CAMS pilot program to include 32 clinicians and trainers across the health system. The donor asked that KVC also use their gift to attract additional funders to support more clinicians and trainers beyond the pilot. While additional funding would be needed to scale, this first seed funding established a proof of concept to begin the CAMS training process.

Step 4: Conduct CAMS Trainings

In February 2024, 32 clinicians and clinical leaders participated and completed the CAMS Trained™ program.Throughout the program’s 10 hours of online coursework and 4 hours of consultation calls, KVC clinicians worked closely with Dr. Gregorian, Dr. Melinda Moore, and the entire CAMS team to gain direct skills, knowledge, and confidence to effectively assess and treat suicidal patients. This pilot group also completed role-play training and the CAMS-4Teens® training to learn how to work with adolescents and their parents/caregivers.

Moore, Anderson, and other cohort leaders stayed closely engaged throughout the training to ensure everyone continued to feel informed and empowered. Gregorian also remained involved to support the clinicians through consultation calls and answering questions as they arose.

Step 5: Put CAMS into Practice

The key to implementation would come from giving clinicians the opportunity to apply CAMS in practice and build their confidence.

In April 2024, 10-15 clinicians began utilizing CAMS with patients. This phased approach allowed the team to focus first on successful uptake of the model, ensuring clinicians felt supported as they navigated suicide-specific conversations and interventions using a new framework. Moore reconnected with Dr. Melinda Moore, the CAMS-care Consultant who hosted the role-play training and consultation calls for the cohort.

Step 6: Scale Across the System of Care

After the initial CAMS training and implementation with 32 clinicians across the health system, KVC continued seeking funding to scale the model.

KVC Kansas secured a new $35,000 grant from the state to train 40 more clinicians in CAMS and the team began to identify and create a plan.

Camber Mental Health, KVC’s team of inpatient and residential psychiatric treatment experts, budgeted $18,000 to train 12 therapists in CAMS (3 per campus). They plan to seek state funding to train the remainder of their clinicians in CAMS.

In 2025, the State of Kansas made a second gift of $35,000 to train staff in Dialectical Behavior Therapy (DBT), to treat the drivers identified in the CAMS Framework and strengthen treatment for youth experiencing foster care.

The Kentucky team also found local partners who wanted to invest in suicide prevention in the community. In May 2025, Lexington, KY-based Valvoline, a national leader in automotive maintenance, partnered with KVC Kentucky by contributing funding to train 53 clinicians in CAMS.. Valvoline’s donation also provided long-term sustainability of the model, funding three licensed practitioners to become CAMS trainers.

In total, in just under two years, KVC has trained 100 clinicians in CAMS across three subsidiaries. Their goal is to train all 450 clinicians nationwide.

While all six of KVC’s local teams have recognized the benefits and plan to implement CAMS, their timelines have varied based on their ability to secure funding. KVC’s teams in Missouri, Nebraska and West Virginia are still in the process of seeking funding to begin training.

Leaning On Each Other to Save Lives

Implementing new and different modalities into your system of care takes work. It takes resources — time, money, and effort. For mental health organizations, many of whom are already stretched thin, implementing something new may feel overwhelming and complicated. Our hope is that this guide can provide a practical model for replicating KVC’s successful implementation through its dedicated leadership, efficient resource use, and collaborative partnership with CAMS.

One of the key components to strengthening your system of care is, of course, funding. Government grants used to be a primary source of funding for mental health services. But recent uncertainty emphasizes the importance of diversifying your pipeline so people can receive the right life-saving support at the right time.

Private philanthropic funding is a critical and effective source. Where to search for it may not be obvious at first. But sometimes we find it in the most unexpected and creative places— like the initial private funder who provided KVC with $25,000 to kickstart training or Valvoline’s larger partnership to save lives.

Anderson shares, “Anyone can do this. It’s not too expensive. It’s not out of reach. But you don’t need to do it alone. Lean on us. Take what KVC has learned and achieved as an organization, and do it even better.”

Please reach out to the CAMS-care team here to learn more. Connecting with you to help you strengthen your system of care is why we’re here.

We are made to live in connection with others. Together, we are committed to creating a world without suicide.

LEARN MORE: KVC Health Systems Funding Proposal Template

After Your Child’s Suicide Attempt

Posted on by Heidi Hamamoto

What to Do After Your Child’s Suicide Attempt — and How CAMS-Care Can Help

When a child has attempted suicide, the days and weeks that follow are often filled with fear, confusion, guilt, and uncertainty. Many parents describe feeling overwhelmed — unsure of what to say, what to do next, or how to help their child begin to heal. The video Parents to Parents: After Your Child’s Suicide Attempt was created to speak directly to these very real experiences, offering guidance from both clinicians and other parents who have walked this difficult path.

This guidance aligns with principles from the Zero Suicide Initiative, an organization that offers evidence-based, suicide prevention consultation and guidance. Research on the Zero Suicide Framework shows that care is improved (individually and at a system level) when it is proactive, collaborative, and specifically focused on suicide risk rather than general mental health alone.

The video linked at the bottom of this page can help parents understand what recovery actually looks like after an attempt: how to talk with their child, how to create safety, and how to partner with clinicians in a structured and hopeful way during a frightening time.

1. Acknowledge the Emotional Impact

First and foremost, it’s important for caregivers to recognize and validate their own emotions. Guilt, fear, anger, panic, numbness, and even relief can all coexist in the aftermath of a suicide attempt. These feelings are understandable — and common.

The video underscores that, while it can feel isolating, parents are not alone, and their reactions are shared by many families who have survived this crisis.

2. Understand What Comes Next

After the immediate medical response (emergency care, hospitalization if needed), the focus shifts to support and safety. This includes:

  • Co-creating a safe home environment by removing/securing or reducing access to potential means of harm.
  • Engaging with clinicians and mental health providers to initiate follow-up care, including therapy and psychiatric support.
  • Listening openly to your child’s feelings and thoughts without judgment, and letting them know they are loved, valued, and safe. The film encourages parents to learn what signs to watch for, how to talk about the attempt with their child, and how to make mental health care accessible.

3. Seek Evidence-Based Suicide-Focused Care

One essential piece in a child’s recovery journey is accessing evidence-based therapeutic approaches that focus specifically on suicidality rather than general mental health management alone. One such model is the Collaborative Assessment and Management of Suicidality (CAMS) — often referenced in suicide care communities and clinical settings.

CAMS is a suicide-specific treatment framework that actively involves the young person in identifying what is “driving” their suicidal thinking and collaboratively building a plan to address those drivers. It’s not a rote checklist; it’s a flexible, empathic approach where the clinician and child (or family) work together to:

  • Assess suicidal risk in depth
  • Create personalized safety and stabilization plans
  • Build treatment beyond safety and stability that moves teens towards lives they find worth living
  • Track progress and adapt care as needed

This model has been supported by research showing reductions in suicidal ideation, hopelessness, and distress, and improved engagement with care — all critical in the period after an attempt.

CAMS-4Teens® is a framework in which a clinician works with the parents to keep the home safe and provide guidance on how best to support your child through a course of CAMS treatment( typically six to 8 one-hour sessions) using the Stabilization Support Plan (CAMS-4Teens: Working with Parents).

Parents can locate a CAMS Trained™ clinician in their area using the CAMS‑care Clinician Locator.

4. Build a Support Team Around Your Child

Recovery is rarely a solo journey. The video highlights the value of connecting with both professional and community support — including family therapists, school counselors, peer support groups, and other caregivers who understand the experience. Parents who have been there often say that having someone to talk to — whether a trained provider or another parent who has survived similar circumstances — can make all the difference.

5. Maintain Hope and Patience 

Perhaps the most crucial message is one of hope. While a suicide attempt is a serious and frightening event, it does not mean a child is beyond help or that recovery isn’t possible. With appropriate care, safety planning, ongoing support, and open, compassionate treatment and communication, many families find their way back to stability and connection. Over time, parents and children can work toward healing together — learning new ways to cope, to stay connected, and to build a future worth living.

Please visit Supporting Parents | Zero Suicide where the film can be viewed in chapters and there are additional resources for healthcare providers, faith leaders, and schools.

Black Youth Suicide: Investigation of Current Trends and Precipitating Circumstances

Posted on by STOLBER Digital

Black Youth Suicide

Seeing rising suicide rates in certain populations is always a cause for concern. It is especially concerning when these rates are happening among young people. In the U.S., suicide rates among Black youth have been increasing in recent years. While there are many possible factors, this should signal that work needs to be done and change needs to be made. 

 

Suicide Trends Affecting Black Youth

From 2018 to 2021, suicide rates increased from 8.2% to 11.2% for Black youth ages 10–24. [1] It was the third leading cause of death for this age demographic in 2022. [2] When looking further back, in the last 25 years, self-reported Black youth suicide attempts have increased by a staggering 73%. [3] Among Black youth, suicide rates for males were four times higher than females in 2021. [4]

 

According to the Suicide Prevention Resource Center, suicide rates among Black populations peaked for youth between the years 2011–2020. There was a sharp spike in suicide rates starting for those around age 15 with the highest rates being in the 25–34 age range. However, rates slowly and steadily declined with each age group afterwards. This pattern is noticeably different than that of the overall U.S. population, where the highest suicide rates happen between the ages of 45–54 as well as 75 and older. [5] These numbers signal a huge concern that Black youth do not have appropriate mental health support. 

 

Why are Black Youth at Risk?

Black communities face various barriers to treatment and support when it comes to mental health and suicide prevention. Youth may face particular challenges when it comes to finding and accessing limited resources. They also deal with other risk factors that often surround them. These difficulties can put them at a disadvantage. Here are a few of the leading factors when it comes to suicide risk among black youth. 

 

COVID-19 pandemic

The pandemic hit some communities harder than others. Youth in particular were put in a difficult position. They had to adjust to remote learning, miss out on important milestone events, and were isolated from their friends. Black youth specifically may have faced even more difficulties, especially those living in low-income areas or households. Some segments of the Black youth population struggled greatly. They faced challenges from not having the tools or technology to keep up with school from home. Others were affected by being stuck in an abusive home environment. A study from the state of Maryland found that suicide rates doubled for Black youth during the early days of the pandemic. [6] However, it’s important to remember that even before the pandemic, suicide rates in Black youth were already rising, signaling that other factors have been playing a role.

 

Trauma exposure

Another contributing role in Black youth suicide is the exposure to trauma, violence, or other adverse childhood experiences (ACEs). Racial discrimination is one example of an ACE. This can be detected in children as young as six years old and is likely to stick with them throughout their lives. [7] Additionally, Black youth who are living in racially segregated and low-income areas are more likely than their peers to experience or witness violence in their families or neighborhoods. [8] Generational trauma may also be present in those whose parents or grandparents experienced violence, abuse, or discrimination. About 65% of Black youth report experiencing some kind of trauma in their lives. [9]

 

Limited access to culturally appropriate mental health care

Many Black communities are faced with barriers when it comes to receiving mental health care, especially care that is culturally appropriate. Socioeconomic disparities play a big factor, making it difficult for many in Black communities to access and afford the care they need. Only about 25% of Black people in the U.S. seek mental health care treatment, compared to 40% of white people. [10] Finding culturally appropriate mental health care is also important—yet it can be another barrier. Only about 2% of the U.S. psychologists are Black. [11] Seeing a Black mental health professional may not feel necessary to some. However, it’s important to find someone who is trained to provide culturally sensitive care. This creates a safe, judgement-free space and helps trust be more easily built. 

 

Taking Steps Toward Black Youth Suicide Prevention

In order to start seeing a decline of suicide rates among Black youth, change has to be made across the board. First, investing in more research specifically focused on Black youth can be a way to shed more light on this growing problem. It can help others see that larger, systemic change needs to happen within Black communities. This includes better and more affordable access to quality healthcare. Additionally, the healthcare provided should be culturally appropriate. Finding ways to support current and future Black psychologists is another step in helping Black youth get access to culturally sensitive care. Finally, it’s important to continue to have open conversations around mental health to break the stigma. Many communities continue to push the narrative that opening up makes a person appear weak. Families and communities need to become safer places for young people to share their feelings, experiences, and ways they may be struggling.

Black youth need more support now than ever when it comes to their mental health. From the struggles of the pandemic to lack of appropriate and accessible resources, many in this population feel stuck and don’t know where to turn when they’re struggling. However, steps can be taken to help Black youth feel seen, heard, and supported. Through continual small steps and increased public awareness of this crisis, the seeds for change can be planted. This can start to positively impact Black communities and future generations.

If you’re curious to learn more, watch Strengths-Based Approaches to Suicide Prevention in the Black Community, an on-demand webinar hosted by Jasmin Brooks Stephens, PhD. In this talk, Dr. Brooks Stephens covers socio-cultural risk factors for Black youth as well as outlines steps that can be taken to address this crisis. 

Remember, if you or someone you know is struggling or in a crisis, the 988 Suicide & Crisis Lifeline is available.

 

Sources:

[1] https://www.cdc.gov/mmwr/volumes/72/wr/pdfs/mm7206a4-h.pdf 

[2] https://minorityhealth.hhs.gov/mental-and-behavioral-health-blackafrican-americans 

[3] https://theactionalliance.org/sites/default/files/ring_the_alarm-_the_crisis_of_black_youth_suicide_in_america_copy.pdf 

[4] https://minorityhealth.hhs.gov/mental-and-behavioral-health-blackafrican-americans 

[5] https://sprc.org/about-suicide/scope-of-the-problem/racial-and-ethnic-disparities/black-populations/ 

[6] https://pmc.ncbi.nlm.nih.gov/articles/PMC10227859/ 

[7] https://pmc.ncbi.nlm.nih.gov/articles/PMC9035019/

[8] https://www.nctsn.org/sites/default/files/resources/complex_trauma_facts_in_urban_african_american_children_youth_families.pdf 

[9] https://www.mcleanhospital.org/essential/black-mental-health 

[10] https://www.mcleanhospital.org/essential/black-mental-health 

[11] https://www.mcleanhospital.org/essential/black-mental-health 

How CAMS Empowers Families to Support Suicidal Loved Ones

Posted on by STOLBER Digital

Youth mental health remains a growing concern in the U.S. According to the Centers for Disease Control and Prevention (CDC), suicide is the second-leading cause of death for teens and young adults between the ages of 10–34 in the U.S. [1] Additionally, 36.7% of young adults ages 18–25 have mental health needs that are not being treated. [2] 

It is common for family members, especially caregivers, to feel overwhelmed. They may wonder what to do when a loved one talks about suicide. CAMS (Collaborative Assessment and Management of Suicidality) is an evidence-based treatment for suicide that allows family members to be a part of the process. It puts emphasis on the “collaborative” aspect. Rather than teaching and handing off the tools to the at-risk person to manage themselves, CAMS strives to involve parents and caregivers. The Stabilization Support Plan is one way that CAMS does this. This plan provides guidance to family members to help support their child’s treatment moving forward. This helps create a bigger system of support for the person who is struggling.  

The Role that Family Plays

Family members and caregivers play crucial roles in helping support their child’s mental health. Adolescence is often a time of instability and change—from changes in friendships to increased demands at school and other activities. Children and teens who are close with their family members have positive, built-in relationships with people they can rely on for help and support through the ups and downs. Here are a few specific ways that family members can help each other when it comes to mental health and suicide prevention. 

Offering emotional support

In a healthy dynamic, family members can provide emotional support to one another. They provide safe spaces for each other to open up and share about their struggles. Families often have deep bonds from shared experiences, good and bad. They know each other’s history, struggles, and triumphs. They are often the first place that people go to with those struggles and triumphs. Having people available to lean on during these times can be extremely helpful.  

Detecting early warning signs of suicide

Family members may be more in-tune and aware of certain warning signs, sensing when things seem “off.” They can easily detect abnormal behavior since they’re familiar with what normal behavior looks like. They are often able to be on alert for signs of distress. Being able to identify warning signs and abnormal behaviors in someone is a key first step to suicide prevention.

Being involved with treatment

When it comes to treatment, family members and caregivers are able to be more easily and seamlessly involved than those on the outside. Parents and caregivers can help their child stay healthy. They can manage logistics like scheduling and driving to appointments. They can also encourage their child to follow treatment plans. 

Family: A Protective Factor 

When talking about suicide, risk factors and protective factors are important to discuss. Risk factors are things that make suicide more likely. Protective factors are things that make suicide less likely. Some people are naturally more at risk than others depending on their background and living situation. According to the Suicide Prevention Resource Center, social isolation can be a big risk factor. Connectedness to other individuals, community, and family is a protective factor. [3] Therefore, it’s important for families to be present and know how to help their child or adolescent through their struggles.

Ways CAMS Supports Family Involvement

Unlike many other types of treatment methods, CAMS puts a large emphasis on collaboration when it comes to working with and supporting the at-risk individual. CAMS is set up to help family members be involved and take an active role in their loved one’s treatment, especially when dealing with parents and children. One way is through CAMS-4Teens®. CAMS-4Teens is a specific method of using the CAMS Framework® to treat children, teens, and young adults who are struggling with thoughts of suicide. Parents and caregivers are engaged in this process, as well. They are given expectations and information up front about the treatment. They are updated regularly as the treatment goes on. They join sessions to learn about their child’s “suicidal drivers.” They also discuss stabilization and support plans, among other topics.

Allowing parents to have a more active role in their child’s treatment allows for open communication and helps reduce the stigma about mental health and suicide. Parents and caregivers can learn about what leads to thoughts of suicide. They can also understand the CAMS therapy approach. This knowledge helps them better understand their child’s mind. 

Benefits of CAMS for Families

CAMS not only benefits the person at risk, but it can help families as a whole grow closer and move forward together in confidence. Here are a few of the specific areas in which families can benefit when working with CAMS.  

Insight into the issues

Many young people, especially teenagers, struggle with issues related to friendships, insecurity, and comparing themselves to their peers. In CAMS, the patient is always listened to first. This helps the therapist see the person’s suicidal thoughts from their point of view. This makes it easier to share these thoughts with family members who can then gain a better understanding.  

Greater sense of control and direction

CAMS allows parents and caregivers the opportunity to get a glimpse into what is going on

and what their role is in helping their child. This is helpful for the children but also helpful for the parents. It gives them a greater understanding and knowledge about what tools and techniques their child is learning to deal with their difficult thoughts and feelings. 

Strengthening trust and relationships

When mental health is openly talked about, trust is more easily built. Family members of any age can benefit from these open conversations around mental health and struggles. When parents and caregivers see how serious the issue is, it helps their child. They also learn what is being done to help. This way, the child can trust that their parents care about what is happening. 

Increased confidence in dealing with a crisis

A common fear that many parents and caregivers have is that they will make a situation worse by saying or doing the wrong thing, particularly in a moment of crisis. CAMS works with parents to put a plan in place for dealing with emergencies. That way, if a crisis happens, parents and caregivers will know how to respond appropriately.

Warning Signs to Watch For

It’s always important to stay aware of the warning signs of suicide, especially because they may look different for people of different ages. Here are some warning signs to watch for from the Substance Abuse and Mental Health Services Administration (SAMHSA): [4]

Warning signs in adults:

  • Talking about or making a plan for suicide
  • Behaving recklessly or acting agitated
  • Talking about feeling trapped or like a burden
  • Increased use of alcohol or drugs
  • Withdrawing or isolating from others
  • Changes in sleep (increased or decreased)
  • Showing signs of rage 
  • Displaying extreme mood swings

Warning signs in youth and children:

  • Expressing hopelessness about the future
  • Displaying severe or overwhelming emotional distress
  • Withdrawing or isolating from others
  • Changes in sleep (increased or decreased)
  • Sudden anger or hostility that seems out of character
  • Increased irritability 

Supporting a loved one who is struggling with suicidal ideation can feel overwhelming and even scary, especially those who feel ill equipped. CAMS aims to help families by offering them a lifeline and including them on the healing journey. CAMS helps parents and caregivers by encouraging open talks about struggles. It focuses on what matters most to the person at risk. This way, they gain the tools and confidence to support their loved one on the path to recovery.  

Curious to learn more about CAMS-4Teens? See more information in this article here: Proven CAMS-4Teens Strategies to Treat Adolescent Suicide. For those interested in or pursuing CAMS-Trained™ designation, check out our on-demand video CAMS-4Teens: Working with Parents. This 3-hour video training covers how therapists can work with parents to support the use of CAMS treatment with their child using the Stabilization Support Plan. 

For more help and tips on supporting a loved one, see this guide from the Center for Suicide Research and Prevention with resources.

Remember, if you or someone you know is in crisis, reach out to the 988 Suicide & Crisis Lifeline via call, text, or online chat.

 

Sources:

[1] https://www.cdc.gov/nchs/data/vsrr/vsrr024.pdf
[2] https://www.samhsa.gov/data/sites/default/files/reports/rpt47095/National%20Report/National%20Report/2023-nsduh-annual-national.pdf
[3] https://sprc.org/risk-and-protective-factors/
[4] https://www.samhsa.gov/mental-health/suicidal-behavior/warning-signs

Colorado’s Blueprint for Suicide-Specific Care: How Children’s Hospital Colorado’s Crisis Clinic Empowers Youth through Collaborative Models

Posted on by erics
How Children’s Hospital Colorado’s Crisis Clinic Empowers Youth through Collaborative Models
The staff of Children’s Hospital Colorado’s new Crisis Clinic meeting with Dr. David Jobes, Creator of the Collaborative Assessment and Management of Suicidality (CAMS) Framework®.

The United States is experiencing a national emergency in child and adolescent mental health. According to the recent Youth Risk Behavior Survey Data Summary & Trends Report: 2013–2023, surveying high school students, experiences of violence, poor mental health, and suicidal thoughts increased over the past decade. Today, suicide is the second leading cause of death for youth and young adults ages 10-24. In Colorado—a state with one of the nation’s highest suicide rates historically—the youth mental health crisis is especially severe. Only 22% of youth who have a mental illness are receiving care.

While the Office of Suicide Prevention (OSP) within the Colorado Department of Public Health and Environment has made significant strides in the state’s suicide prevention, intervention, and postvention efforts, a critical gap in pediatric mental health services remains. In response, Children’s Hospital Colorado (Children’s Colorado) is addressing the high number of children and adolescents experiencing suicidal thoughts, behaviors, and other mental health concerns that are overwhelming pediatric emergency departments and inpatient units.

The Pediatric Mental Health Institute (PHMI), a department within Children’s Colorado, developed a groundbreaking outpatient Crisis Services strategic plan to build a robust continuum of care for youth experiencing mental health crises, including suicidal thoughts and behaviors. The first initiative in this plan—the launch of a rapid-access, time-limited Crisis Clinic—is showing early success in transforming pathways to care for youth at risk for suicide. Enhanced by the Collaborative Assessment and Management of Suicidality (CAMS) Framework®, this innovative model is redefining crisis intervention and expanding access to timely, evidence-based treatment.

Housed on the University of Colorado’s (CU) Anschutz Medical Campus and in partnership with the CU Department of Psychiatry, the Crisis Clinic started seeing its first patients in June 2024. By blending models from leading thought partners across the nation, selecting the evidence-based Collaborative Assessment and Management of Suicidality (CAMS) Framework® to treat patients, and leveraging a multidisciplinary team approach, the Crisis Clinic is transforming mental health for youth across the state through accessible and tailored outpatient services, empowering patients and families in their fight against suicide.

Blending Care Models to Build a Groundbreaking Outpatient Clinic

As part of the growing youth mental health crisis in Colorado and across the nation, children and adolescents experiencing suicidal thoughts and behaviors often seek care at the emergency department. From there, providers typically refer them to inpatient psychiatric units or discharge them with recommendations for outpatient services. However, due to hospital boarding, long waitlists, insurance limitations, and other barriers to accessing care, patients and families often face difficulties navigating mental health systems and connecting to care.

In response to this complex crisis and the need for more rapid-access care pathways, Children’s Colorado took action through advocacy and coordinated strategic planning efforts. Under the leadership of Dr. Beau Carubia, child psychiatrist and Medical Director for the Consultation-Liaison/Emergency (CL/ED) Division; Dr. Anastasia Klott, child psychiatrist and Interim Associate Medical Director of Crisis Services; and Betsey Bucca, LCSW, Associate Clinical Manager of Consultative/Crisis, the experienced mental health providers at Children’s Colorado came together to create something different. Dr. Collette Fischer, psychologist, joined the team as the Interim Program Director of Crisis Services, and in collaboration with process improvement specialists, the team worked to design and implement new models of care.

Their broad Crisis Services strategic plan takes a comprehensive, three-pronged approach to bridge mental health care gaps, integrating rapid-access outpatient care, enhanced emergency department triage, and short-term inpatient stabilization to ensure youth receive timely, individualized support.

Their vision was to first launch the rapid-access Crisis Clinic to provide immediate, evidence-based suicide-focused treatment in an outpatient setting for patients who neither required higher levels of care nor had an established mental health provider. Borrowing inspiration and guidance from other leading institutions nationwide, they developed a flexible, holistic approach that would meet the unique needs of each child.

The Crisis Clinic narrowed its focus to serving youth experiencing suicidal ideation and attempts. Today, the Crisis Clinic serves youth ages 10-17 who experience a range of suicidal ideation, from distressing thoughts to plans and attempts.

Choosing the CAMS Framework for Proven, Evidence-Based Treatment

As part of a multi-year project to implement the Zero Suicide framework across all clinical sites and levels of care at Children’s Colorado, leaders of the Crisis Clinic selected the CAMS Framework for its effectiveness and adaptability. Dr. Fischer, Dr. Klott, Dr. Carubia, and Dr. Jessica Hawks, Clinical Director and incoming Chief of Psychology, were familiar with these models from their research on system-wide transformation and patient-centered care. Additionally, they were familiar with the CAMS Framework based on discussions with a former colleague, and now current faculty at the University of Washington, Dr. Eileen Twohy. “CAMS was the best fit given the amount of evidence backing it,” explained Dr. Klott.

When they explored CAMS further, they discovered that they could tailor the framework to each patient’s unique needs, which aligned seamlessly with their strategic vision. The framework consists of first gathering information about a patient’s experiences and suicide risk, followed by developing a treatment plan, a stabilization plan, and treating patient-identified “drivers” (the problems that compel the patient to consider suicide). Dr. Fischer added, “Because CAMS is a framework, it allows for flexible treatment planning, helping us remain focused on reducing suicide by addressing those unique drivers.”

The Crisis Clinic prioritizes education about the CAMS Framework and its approach to ensure families understand the care model. Alongside partners at OSP, over 40 providers across their network of care participated in the CAMS training. Additionally, Crisis Clinic providers have completed training in CAMS-4TeensⓇ and CAMS Brief Intervention (CAMS-BI™).

Support from the CAMS-care team has prepared the Crisis Clinic to successfully anticipate setbacks with patients, without which the patients might have been re-admitted to higher levels of care. Dr. Fischer added, “The CAMS Framework has been powerful not only for our patients but also for our clinicians.” Most notably, it provides a common language and ensures objectivity through tools like the Suicide Status Form (SSF), which supports outpatient treatment decisions.

Clinicians at Children’s Colorado often refer to a quote that Dr. Jobes shares in training materials: “CAMS empowers clinicians by empowering their patients.”

Leveraging a Multidisciplinary Team Approach for Holistic Pediatric Care

In addition to the CAMS Framework, the Crisis Clinic transforms pediatric mental health care through a multidisciplinary approach. The team consists of Advanced Practice Providers, Behavioral Health Clinicians, Care Coordinators, Psychiatrists, a Psychiatric Pharmacist, and Psychologists, each collaborating to provide holistic services to patients and their families. The roles of a pharmacist for optional medication management and care coordinator for continuity of care ensure a patient-centered, seamless experience during treatment and the post-discharge transition to outpatient or community mental health resources.

Over 6-8 visits, patients work with a dedicated clinician who uses CAMS and complementary modalities to address the drivers of suicidality. The first session spans two hours and entails comprehensive assessment and care planning, with subsequent one-hour sessions focused on progress and adjustment.

Simultaneously, a second clinician supports the family through education, including providing psychoeducation, lethal means counseling, and safety planning. The co-clinician and caregivers use the CAMS Stabilization Support Plan (SSP) to provide ongoing support for the patient’s suicidality.

At the end of each session, the multidisciplinary team huddles amongst themselves to align on progress. They then sync up with the patient and family to plan for the week ahead. Dr. Klott reflected on the process, remarking, “This level of acuity and volume would be overwhelming to navigate alone.”

The Gary Pavilion at Children’s Hospital Colorado at the University of Colorado
The Gary Pavilion at Children’s Hospital Colorado at the University of Colorado’s (CU) Anschutz Medical Campus houses the child and adolescent psychiatry program.

Transforming Communities One Patient and Family at a Time

Between June and December 2024, the Crisis Clinic pilot served 21 patients using the CAMS Framework across 128 total treatment sessions. Patients accessed timely care, with referrals placed before discharge from the emergency department and an average wait time of just 4.6 business days before starting therapy. Overall, the clinical team has observed stabilization in patient-reported ratings related to suicide risk.

According to initial feedback, patients report they learned coping mechanisms and identified contributing drivers of their suicidal thoughts. They valued feeling heard and understood without pressure. They improved communication with family members. They highlighted the importance of efforts to address self-hate and promote self-forgiveness. Dr. Fischer acknowledged how the rapid-access Crisis Clinic is disrupting patterns otherwise seen in the youth mental health crisis, “Without a clinic like this, patients might come back to our Emergency Departments 10 times worse 10 weeks later.”

Beyond offering direct support with the Crisis Clinic and CAMS, Children’s Colorado is spearheading a cultural shift, encouraging open conversations about suicide to reduce the stigma. This includes community screenings and dialogues around the documentary, My Sister Liv, which emphasizes that talking openly about suicidality reduces suicidality rather than increases it. They also share tools such as hotlines and community resources. By addressing a crisis through a suicide-specific lens, they underscore their mission to treat crises not just as moments of distress but as opportunities to empower patients and families toward healing.

Through rapid outpatient services to divert unnecessary hospitalizations, the evidence-based CAMS Framework for patients and their families, and a multidisciplinary care team, Children Colorado’s Crisis Clinic is redefining suicide-specific care for youth in Colorado. While much work remains to reach more youth experiencing mental health crises and close the care gap in Colorado, the Crisis Clinic’s unique, blended model sets a powerful example for other providers focused on reducing youth suicidality to follow.

2024 CAMS Update and Introducing CAMS Brief Intervention

2024 CAMS Update and Introducing CAMS Brief Intervention

In this suicide prevention month webinar, Dr. Jobes will discuss recent updates based on clinical trial research, clinical use of CAMS, and training developments related to CAMS. With five on-going randomized controlled trials and a series of recent publications, there is much news to report on all things CAMS. Dr. Jobes will then be joined by Dr. Ray Tucker who will present on the emerging use of CAMS as a single-session brief inpatient and/or emergency department intervention with promising preliminary evidence. There are now several new research efforts to replicate and extend early CAMS-BI™ findings. Join us for this exciting update and introduction to CAMS BI as a novel and much needed suicide-focused brief intervention.

David A. Jobes, PhD

About David A. Jobes Ph.D. ABPP

David Jobes, PhD, ABPP, is the founder of CAMS-care, LLC. He began his career in 1987 in the Counseling Center of the Catholic University of America, where he developed a suicide risk assessment tool for college students that evolved into CAMS. Dr. Jobes is now a Professor of Psychology and Associate Director of Clinical Training at Catholic; he has trained thousands of mental health professionals in the United States and abroad in evidence-based assessment and treatment of suicide risk and the use of CAMS.

Dr Raymond Tucker Headshot

About Dr. Raymond P. Tucker

Associate Professor of Psychology, Louisiana State University (LSU)
Clinical Assistant Professor of Psychiatry, Louisiana State University Health Sciences Center (LSUHSC)/Our Lady of the Lake (OLOL),
Raymond P. Tucker is a licensed clinical psychologist and associate professor of psychology at Louisiana State University. There he teaches undergraduate courses in psychology, graduate courses in clinical psychology, and founded the LSU Mitigation of Suicidal Behavior research laboratory. As a clinical assistant professor of psychology at LSUHSC/OLOL, he trains medical staff/students in suicide-specific evidence-based assessment and intervention protocols.

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Attachment-Based Family Therapy: a family safety net approach to suicide treatment

Attachment-Based Family Therapy: a family safety net approach to suicide treatment On-Demand Webinar

For adolescent and young adults, family conflict can drive a suicidal crisis and family support can buffer against it. ABFT aims to identify and address the family events (e.g. divorce) and processes (e.g. high demand, low warmth) that may exacerbate the distress and prohibit the family serving as a safety net. Individual sessions with the patient and the parents prepare them for conversations that address attachment ruptures and disappointment. Not only do these conjoint sessions resolve problems but server as in vivo change events where parents practice new parenting skills and the young person practices new emotion regulation skills. This brief talk will present the essential theory and elements of this well researched empirically supported therapy.

Guy Diamond, Ph.D.

About Guy Diamond, Ph.D.

Guy Diamond Ph.D. is Professor Emeritus at the University of Pennsylvania School of Medicine and Associate Professor at Drexel University in the College of Nursing and Health Professions. At Drexel, he is the Director of the Center for Family Intervention Science (CFIS). His primary work has been in the area of youth suicide prevention and treatment research. On the prevention side, he has created a program focused on training, screening and triage to be implemented in non-behavioral health settings. On the treatment side, he has focused on the development and testing of attachment-based family therapy, especially for teens struggling with depression and suicide. Much of this work has focused on inner city low income families.

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Tips for parents of teens struggling with mental health issues

Many well-meaning parents panic when their child is struggling with mental health issues, which may lead to saying the wrong thing, or not offering the kind of help their teen needs. This article offers effective ways for parents to empower their teens, ask the right questions and determine the level of support the teen may need.

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CAMS-4Teens®: The Complexities of Working with Parents

CAMS-4Teens: The Complexities of Working with Parents On-Demand Webinar

In this hour-long webinar, “CAMS-4Teens: The Complexities of Working with Parents”, there are now three NIMH-funded randomized controlled trials (RCTs) using CAMS with young adults (college students) and adolescents who are suicidal. While CAMS has been used clinically for many years with these populations, RCTs on “CAMS-4Teens” are helping us discern the best possible ways for adapting the intervention and working with this population. Within our clinical trial research we are seeing various challenges–and the promise–of working with teens and their parents using a patient-focused intervention for suicide risk. Based on the early findings, CAMS-4Teens appears to be quite promising and developing ways to help parents to support their child’s suicide-focused treatment is evolving and compelling. This presentation provides an overview of the CAMS-4Teens approach along with an update on the current clinical trial research and emerging recommendations for effective clinical practice with adolescents who are suicidal.

Hosted by Dr. Kevin Crowley, clinical psychologist, private practitioner and CAMS Consultant.

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