Reducing short term suicide risk after hospitalization: A randomized controlled trial of the Collaborative Assessment and Management of Suicidality

This study compared the “next day appointment” (NDA) use of the Collaborative Assessment and Management of Suicidality (CAMS) to treatment as usual (TAU) for individuals discharged from the hospital following a suicide-related crisis. We hypothesized that CAMS would significantly reduce suicidal tho...

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Bibliographic Details
Published in:Journal of affective disorders 2023-01, Vol.320, p.656-666
Main Authors: Comtois, Katherine Anne, Hendricks, Karin E., DeCou, Christopher R., Chalker, Samantha A., Kerbrat, Amanda H., Crumlish, Jennifer, Huppert, Tierney K., Jobes, David
Format: Article
Language:English
Subjects:
Clinical trials
Health services
Hospitalization
Humans
Psychotherapy
Quality of Life
Suicidal Ideation
Suicide - psychology
Suicide Prevention
Suicide/self-harm
Treatment
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Summary:This study compared the “next day appointment” (NDA) use of the Collaborative Assessment and Management of Suicidality (CAMS) to treatment as usual (TAU) for individuals discharged from the hospital following a suicide-related crisis. We hypothesized that CAMS would significantly reduce suicidal thoughts and behaviors as well as improve psychological distress, quality of life/overall functioning, treatment retention and patient satisfaction. Participants were 150 individuals who had at least one lifetime actual, aborted, or interrupted attempt and were admitted following a suicide-related crisis. There were 75 participants in the experimental condition who received adherent CAMS and 75 participants who received TAU. Suicidal thoughts and behaviors, psychological distress, and quality of life/overall functioning were assessed at baseline and at 1, 3, 6, and 12 months post-baseline. Treatment retention and patient satisfaction were assessed at post-treatment. Participants in both conditions improved from baseline to 12 months but CAMS was not superior to TAU for the primary outcomes. A small but significant improvement was found in probability of suicidal ideation at 3 months favoring TAU and amount of suicidal ideation at 12 months favoring CAMS. CAMS participants experienced less psychological distress at 12 months compared to baseline. The study was limited by only one research clinic, lower than expected recruitment, and imbalance of suicidal ideation at baseline. Conclusions: All participants improved but CAMS was not more effective than TAU. The NDA clinic was feasible and acceptable to clients and staff in both conditions and future research should investigate its potential benefit. •CAMS and TAU were deployed successfully as aftercare following inpatient admission.•CAMS was not superior to TAU in reducing suicide attempts or other primary aims.•CAMS was superior to TAU in therapist acceptability ratings for high-risk patients.
ISSN:0165-0327
1573-2517
DOI:10.1016/j.jad.2022.09.042