A systematic review of efficacy of Collaborative Assessment and Management of Suicidality (CAMS) in managing suicide risk and deliberate self-harm in adult populations

Hanratty, D.; Kilicaslan, Jan; Wilding, Helen; Castle, David

doi:10.1177/1039856219848832

Cited by 18 publications

(14 citation statements)

References 23 publications

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“…A recent review by Hanratty, Kilicaslan, Wilding, and Castle (2019) found limited evidence regarding the effectiveness of Collaborative Assessment and Management of Suicidality in reducing suicide risk and deliberate self-harm in adults. However, evidence from the present review was divided between studies favoring clinician assessment of risk (Quinlivan et al, 2017;Wang et al, 2016), and others where clinician assessment of risk did not significantly predict suicide attempts (Brucker et al, 2019;Harrison et al, 2018), or death from suicide (Randall et al, 2019).…”

Section: Discussionmentioning

confidence: 99%

Suicide and Self-Harm Risk Assessment: A Systematic Review of Prospective Research

Saab¹,

Murphy

Meehan

et al. 2021

Archives of Suicide Research

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Objective: Suicide and self-harm are widespread yet underreported. Risk assessment is key to effective self-harm and suicide prevention and management. There is contradicting evidence regarding the effectiveness of risk assessment tools in predicting self-harm and suicide risk. This systematic review examines the effect of risk assessment strategies on predicting suicide and self-harm outcomes among adult healthcare service users. Method: Electronic and gray literature databases were searched for prospective research. Studies were screened and selected by independent reviewers. Quality and level of evidence assessments were conducted. Due to study heterogeneity, we present a narrative synthesis under three categories: (1) suicide-and self-harm-related outcomes; (2) clinician assessment of suicide and self-harm risk; and (3) healthcare utilization due to self-harm or suicide. Results: Twenty-one studies were included in this review. The SAD PERSONS Scale was the most used tool. It outperformed the Beck Scale for Suicide Ideation in predicting hospital admissions and stay following suicide and self-harm, yet it failed to predict repeat suicide and self-harm and was not recommended for routine use. There were mixed findings relating to clinician risk assessment, with some studies recommending clinician assessment over structured tools, whilst others found that clinician assessment failed to predict future attempts and deaths. Conclusions: There is insufficient evidence to support the use of any one tool, inclusive of clinician assessment of risk, for self-harm and suicidality. The discourse around risk assessment needs to move toward a broader discussion on the safety of patients who are at risk for self-harm and/or suicide. HIGHLIGHTSThere is insufficient evidence to support using standalone risk assessment tools. There are mixed findings relating to clinician assessment of risk. Structured professional judgment is widely accepted for risk assessment.

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Section: Discussionmentioning

confidence: 99%

Suicide and Self-Harm Risk Assessment: A Systematic Review of Prospective Research

Saab¹,

Murphy

Meehan

et al. 2021

Archives of Suicide Research

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“…Only one systematic review of CAMS studies has been conducted to date. Hanratty et al (2019) narratively synthesized comparisons of CAMS to alternative interventions in non-retrospective designs (k = 4). The authors concluded that CAMS showed some promise in improving suicidal ideation and some other outcomes, such as hopelessness.…”

Section: Practitioner Pointsmentioning

confidence: 99%

“…While this review (Hanratty et al, 2019) provided an initial examination of CAMS research, it has a number of limitations. First, it did not include RCTs of CAMS that have been published since 2017 (e.g., Jobes et al, 2017;Pistorello et al, 2020;Ryberg et al, 2019).…”

Section: Practitioner Pointsmentioning

confidence: 99%

The effectiveness of the Collaborative Assessment and Management of Suicidality (CAMS) compared to alternative treatment conditions: A meta‐analysis

Swift

Trusty

Penix

2021

Suicide & Life Threat Behav

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Introduction: This meta-analysis aimed to test the efficacy of the Collaborative Assessment and Management of Suicidality (CAMS) intervention against other commonly used interventions for the treatment of suicide ideation and other suiciderelated variables. Method: Database, expert, and root and branch searches identified nine empirical studies that directly compared CAMS to other active interventions. A random effects model was used to calculate the effect size differences between the interventions; additionally, moderators of the effect sizes were tested for suicidal ideation. Results: In comparison to alternative interventions, CAMS resulted in significantly lower suicidal ideation (d = 0.25) and general distress (d = 0.29), significantly higher treatment acceptability (d = 0.42), and significantly higher hope/lower hopelessness (d = 0.88). No significant differences for suicide attempts, self-harm, other suiciderelated correlates, or cost effectiveness were observed. The effect size differences for suicidal ideation were consistent across study types and quality, timing of outcome measurement, and the age and ethnicity of participants; however, the effect sizes favoring CAMS were significantly smaller with active duty military/veteran samples and with male participants. Conclusions: The existing research supports CAMS as a Well Supported intervention for suicidal ideation per Center of Disease Control and Prevention criteria. Limitations and future directions are discussed.

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“…13 The Collaborative Assessment and Management of Suicidality approach (an evidencebased therapeutic framework developed three decades ago for the assessment and management of patients at risk for suicide) has been promisingly adapted for delivery via tele-psychotherapy in recent work, although its effectiveness in reducing the risk of suicide and selfharm among adults remains understudied. 14 Clinical experience suggests that virtual risk assessment may need to be modified, particularly with youth, patients with communication challenges, or patients with suspected psychotic symptoms. The authors have begun work to produce a practice guide for virtual and telehealth-based suicide risk assessment and crisis management.…”

Section: Current Evidence and Future Directionsmentioning

confidence: 99%

Innovations in suicide assessment and prevention during pandemics

Brenna¹,

Links²,

Tran³

et al. 2021

Public Health Res Pract.

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A systematic review of efficacy of Collaborative Assessment and Management of Suicidality (CAMS) in managing suicide risk and deliberate self-harm in adult populations

Cited by 18 publications

References 23 publications

Suicide and Self-Harm Risk Assessment: A Systematic Review of Prospective Research

Suicide and Self-Harm Risk Assessment: A Systematic Review of Prospective Research

The effectiveness of the Collaborative Assessment and Management of Suicidality (CAMS) compared to alternative treatment conditions: A meta‐analysis

Innovations in suicide assessment and prevention during pandemics

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