An Evidence-Based Clinical Approach to Suicide Prevention in the Department of Defense: The Collaborative Assessment and Management of Suicidality (CAMS)

Abstract

There are few evidence-based approaches for the treatment of suicidality particularly within the Department of Defense settings (DoD) (Schoenbaum, Heinssen, & Pearson, 2009). This article describes a relatively new suicide-specific approach called the "Collaborative Assessment and Management of Suicidality" (CAMS). There is growing evidence that CAMS can meaningfully impact suicidal ideation, overall symptom distress, increase hope, and may positively impact non-mental health utilization. The prospect of using CAMS within military treatment facilities is discussed as a means of clinically assessing and treating suicidal ideation and related behaviors for military personnel.The various psychological stressors associated with recent U.S. military operations, including Operation Iraqi Freedom (OIF), Operation Enduring Freedom (OEF), and Operation New Dawn (OND), have come to the forefront of attention for military leaders, policymakers, and the broader U.S. population. Related to these concerns has been the alarming rise in military suicide rates over the past decade. Between 2001 and 2008, the Department of Defense (DoD) has experienced roughly a 50% increase in suicide deaths of active duty service members,

Associations of Suicide Prevention Trainings with Practices and Confidence among Clinicians at Community Mental Health Centers

“…The finding that QPR training was not related to higher practice scores among behavioral health providers is not entirely surprising giving that the skills taught in QPR are aimed at individuals who do not work primarily in the behavioral health field and might be too elementary for mental health providers (QPR, 2017). In fact, previous research documented that QPRT (Question, Persuade, Refer, and Treat) is not associated with greater knowledge about conducting suicide risk assessment, safety planning, and documenting risk among mental health providers (Gryglewicz, Chen, Romero, Karver, & Witmeier, 2017).…”

“…Overall, these results suggest that CAMS followed by DBT training are superior at impacting implementation of evidence-based practices of suicide care. These trainings are well known for providing clinicians with novel and specific tools for the 1152 SUICIDE PREVENTION TRAINING treatment of at-risk individuals who experience suicidality that go beyond basic training on best practices related to suicide prevention (Jobes, 2012;Landes et al, 2016;Tørmoen et al, 2014). CAMS, in particular, was specifically created to target suicidality by identifying distal and proximal risk factors and drivers of suicidal intention.…”

“…One of the advantages of CAMS is that treatment is designed to be a collaborative process in which both the clinician and the client decide the focus of intervention to reduce suicidality (Ellis, Rufino, & Allen, 2017;Jobes, 2012). The empirical evidence on the effectiveness of CAMS to target suicidality is continuing to grow; for example, CAMS demonstrates effectiveness in reducing suicide ideation, overall distress, and increasing hope (Ellis, Rufino, Allen, Fowler, & Jobes, 2015;Jobes, Lento, & Brazaitis, 2012;Ryberg et al, 2016). Results suggested that all trainings but QPR were associated with greater self-report confidence on providing suicide-specific care, with AMSR being a stronger predictor of these scores.…”

“…Results suggested that all trainings but QPR were associated with greater self-report confidence on providing suicide-specific care, with AMSR being a stronger predictor of these scores. As mentioned above, it appears that QPR, although effective for nonmental health providers in identifying individuals at risk of suicide (Cross et al, 2007(Cross et al, , 2010Litteken & Sale, 2017), might not be as effective in increasing confidence among clinicians who may already have the knowledge and skills associated with this training (Gryglewicz et al, 2017). All of the other trainings seem to have incremental value in their likelihood to increase comfort and delivery of best practices for suicide prevention (Ellis et al, 2017;Landes et al, 2016;Marshall et al, 2014;Tørmoen et al, 2014).…”

Reflections on Suicide Among Soldiers

“…We are now attempting to replicate our promising correlational and randomized clinical trial results (Comtois et al, 2011) within a wellpowered RCT with suicidal infantry Soldiers. Based on our research to date, we look forward to the prospect of CAMS being used more widely and effectively with suicidal service members (Jobes, Lento, & Brazaitis, 2012).…”