Video segments in e-CAMS were modeled after the assessment, management, monitoring, and resolution (resolution is three sessions with no suicidal behavior) processes of a 12-session CAMS intervention. The patient was role played by a veteran, and the clinician by Jobes. Other diversity-specific video segments included CAMS delivery with a geriatric and a female, Hispanic veteran and VA providers.19 Interactivity was increased by the participants completing the SSF forms to assess and monitor the suicidality and track outcomes for the video segments. The participants received six continuing education unit credits.
As the science of CAMS continues to expand, exciting new training opportunities are in development including a revision of the original CAMS manual5 and a new interactive e-learning and consultation model developed by Jobes.
In summary, CAMS is an effective intervention for intervening with those at risk for suicide. There is now evidence to support the impact on patient and provider outcomes and additional studies are in process within the U.S. and other countries. CAMS is adaptable to a multitude of clinical settings and populations, and training is applicable for interprofessional mental health clinicians.
Given the magnitude of suicide mortality and morbidity, it is critical that clinicians be trained and coached to adopt systematic, suicide-specific evidence-based interventions, such as CAMS. For those interventions to be the most effective, mental health systems need to focus on suicide-specific performance improvement, a culture of safety, and the assessment and facilitation of systems change.
Janet York, PhD, PMHCS-BC, FAAN, is the Director of the Psychiatric Mental Health Nurse Practitioner Residency at the Ralph H. Johnson VA Medical Center in Charleston, South Carolina, and an adjunct research professor of nursing at the Medical University of South Carolina.
- Drapeau C, McIntosh J. American Association of Suicidology. October 2014.
- Schmitz W, Allen M, Feldman B, et al. Preventing suicide through improved training in suicide risk assessment and care: an American Association of Suicidology Task Force Report addressing serious gaps in U.S. mental health training. Suicide Life Threat. 2012;42(3):292–304. doi:10.1111/j.1943-278X.2012.00090.x.
- U.S. Department of Health and Human Services (HHS) Office of the Surgeon General and National Action Alliance for Suicide Prevention. 2012 National Strategy for Suicide Prevention: Goals and Objectives for Action. Washington, DC: HHS, September 2012. http://www.surgeongeneral.gov/library/reports/national-strategy.
- Suicide Prevention Resource Center, American Association of Suicidality Assessing and managing suicide risk: Core competencies for mental health professionals. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2008.
- Jobes D. Managing Suicidal Risk: A Collaborative Approach. New York, NY: Guilford; 2006.
- Magruder K, York J, Jobes D, et al. Patient and provider outcomes of e-learning training in CAMS. EDU 08-424. Health Services R&D, Department of Veterans Affairs. 8/09-9/13.
- Jobes DA. The collaborative assessment and management of suicidality (CAMS): an evolving evidence-based clinical approach to suicidal risk. Suic Life Threat Behav. 2012; 42(6): 640–53.
- Arkov K, Rosenbaum B, Christiansen L, et al. Treatment of suicidal patients: the collaborative assessment and management of suicidality. Ugeskr Laeger. 2008; 170(3): 149–53.
- Comtois KA, Jobes DA, O’Connor S, et al. Collaborative assessment and management of suicidality (CAMS): feasibility trial for next-day appointment services. Dep Anx. 2011; 28: 963–72.
- Ellis T, Green K, Allen J, et al. Collaborative assessment and management of suicidality in an inpatient setting: results of a pilot study. Psychother. 2012; 49(1): 72–80.
- Jobes D, Comtois K, Brenner L, et al. Clinical trial feasibility studies of the Collaborative Assessment and Management of Suicidality (CAMS). In: O’Connor R, Platt S, Gordon J, editors. International Handbook of Suicide Prevention: Research, Policy and Practice. WestSussex, UK: Wiley–Blackwell; 2011, 383–400.
- Jobes DA, Kahn-Greene E, Greene JA, et al. Clinical improvements of suicidal outpatients: examining suicide status form responses as predictors and moderators. Arch Suicide Res. 2009; 13(2): 147–59.
- Jobes DA, Jacoby AM, Cimbolic P, et al. Assessment and treatment of suicidal clients in a university counseling center. J Couns Psychol.1997; 44: 368–77.
- Jobes DA, Wong SA, Conrad AK, et al. The collaborative assessment and management of suicidality versus treatment as usual: a retrospective study with suicidal outpatients. Suicide Life Threat Beh. 2005; 35(5): 483–97.
- Bagley S, Munjas B, Shekelle P. A systematic review of suicide prevention programs for military or veterans. Suicide Life Threat. 2010;40(3):257–65.
- Ghahramanlou-Halloway M, Cox D, Fritz D, et al. An evidence informed guide for working with women and veterans. Prof Psychol Res Pract. 2011;42(1):1–7.
- Joint Commission. Behavioral Health Care 2013 National Patient Safety Goals http://www.jointcommission.org/standards_information/npsgs.aspx.
- Shoenbaum M, Heissen R, Pearson J. Opportunities to improve interventions to reduce suicidality: civilian “best practices” for army consideration. Washington DC: Department Health Human Services, National Institute of Health, National Institute of Mental Health; 2009.
- Marshall E, York J, Magruder K, et al. Implementation of online suicide-specific training for VA providers. Acad Psychiat. 2014. doi: 10.1007/s40596-014-0039-5 .
- Magruder K, York J, Knapp B, et al. RCT evaluating provider outcomes by suicide prevention training modality: In-person vs E-learning. Manuscript in press.