Collaborative assessment and management of suicidality for teens: A promising frontline intervention for addressing adolescent suicidality.

Abstract

This pilot open trial examined the feasibility, acceptability, and preliminary outcomes of the Collaborative Assessment and Management of Suicidality for teens (CAMS-4Teens) who presented to outpatient care with suicidal thoughts and behaviors. Participants were 22 adolescents (age 13-17; 59% identified as female) with clinical elevations ($7) on the Suicidal Behaviors Questionnaire-Revised (SBQ-R). Primary outcomes were feasibility and acceptability. We also explored outcomes of suicidal thoughts and behaviors, as well as mixed effects modeling for weekly assessments of the Suicide Status Form (SSF) Core Assessment constructs. Our main implementation outcomes suggest that the intervention is acceptable, appropriate, and feasible to deliver. Clinicians were adherent to the model with high ratings of adherence. In addition, preliminary evaluation of suicidal thoughts and behaviors found a large effect size for reduction in suicidal thoughts. Benchmarking to other adolescent suicide specific interventions and the Collaborative Assessment of Management of Suicidality with adult populations provides promise that suicidal adolescent responses may be on par with established interventions. Findings from the study are preliminary in nature and intended to inform whether CAMS with adolescents is a promising approach to engage and treat patientdefined "drivers" of suicide. The results suggest that a future investigation with power to detect significant change over another active intervention is warranted. Clinical Impact StatementThis open pilot trial demonstrated that the Collaborative Assessment and Management of Suicidality framework was feasible and acceptable to adolescents and clinicians. It is an important public health priority to increase access to and evidence for suicide-specific intervention strategies that can improve suicide prevention efforts with adolescent populations.

Feasibility and acceptability of caring contacts texts for suicide prevention among veterans recently separated from military service.

“…The FIM and AIM are four-item questionnaires each using a 5-point Likert-type scale. Total scores on each range from 4 to 20, with higher scores indicating greater feasibility and acceptability and scores above 12 (i.e., mean score) indicating the intervention was, overall, feasible or acceptable (Adrian et al, 2022; Pittman et al, 2021). These measures have demonstrated acceptable test–retest reliability and good structural validity (Weiner et al, 2017).…”

Advancing Suicide Intervention Strategies for Teens (ASSIST): study protocol for a multisite randomised controlled trial

“…Pilot work with CAMS for adolescents is also promising. The psychometric validation of the Suicide Status Form (SSF)—the core CAMS assessment tool—indicates that it is valid for use with adolescents and does not need to be adapted or modified for this age group 20. In addition, our preliminary data indicate that CAMS is an effective and efficient intervention for reducing adolescent suicide risk 21.…”

A unique model of care for youth in crisis: A pilot open trial.

“…Care quality metrics recommend that youth seen for acute care for SITB attend an outpatient mental health appointment within 7 days of ED or hospital discharge; however, approximately half of youth receive no care within this period (Fontanella et al, 2020). Finally, inpatient care has not demonstrated compelling change in decreased SITB (Adrian et al, 2022), and some argue may have iatrogenic effects (Ward-Ciesielski & Rizvi, 2021). For these three reasons, outpatient crisis stabilization interventions should be prioritized for development and evaluation.…”