Doctor of Philosophy (PhD)



Document Type



Inpatient psychiatric care is a critical contact point for individuals experiencing suicidal thoughts and behaviors (STB). The Zero-Suicide framework provides useful scaffolding for improving suicide prevention within inpatient psychiatry (i.e., Assess, Intervene, and Monitor [AIM-SP]). Available evidence suggests instruments are available for evidence informed risk assessment but are hindered by low construct validity and a limited collaborative approach. Additionally, extant interventions do not typically target STB and are not optimized for inpatient psychiatric care. The Collaborative Assessment and Management of Suicidality (CAMS) meets the criteria of the Zero-Suicide Framework and is often leveraged as a single session intervention (SSI) but the effects of CAMS as a SSI have yet to be tested. Subjective units of distress (SUDS) and readiness to continue living, measured via the Living Ladder, are two outcomes which may represent the mechanisms of change for STB targeted interventions. The purpose of this study is to test the immediate efficacy of CAMS as a SSI for psychiatric inpatients experiencing reporting STB. Hypotheses are as follows: (1) CAMS will result in a statistically significant improvement in SUDS and (2) Living Ladder score for the majority of patients from pre- to post-session, (3) explore whether changes in outcomes vary according to baseline ratings, and (4) explore whether changes in outcomes are related to self-rated likelihood of Safety Plan use. Results indicate completing CAMS Session 1 is associated with a statistically significant reduction in subjective distress and readiness to continue living from pre- to post-session; some change in outcomes varied as a function of pre-session ratings. Self-rated likelihood of Safety Plan use was unrelated to pre-session ratings in the aforementioned outcomes. Implications discussed include the following: practice implications within inpatient psychiatry, immediate therapeutic gains as signal for long-term recovery, therapeutic supplements to CAMS Session 1, suggestions for scalability to primary care and emergency medicine. The study is limited by a lack of control group, single-item outcome measurement, and lack of follow-up post-discharge to assess longer term recovery outcomes. Results suggest that CAMS Session 1 may be feasible as a SSI for treating STB within inpatient psychiatry.



Committee Chair

Raymond P. Tucker