David A. Jobes

Background: Emergency departments (EDs) are key entry points for many youth experiencing suicidal thoughts and behaviors into mental health care. ED clinicians play a critical role in crisis intervention, prevention, and linking patients to ongoing care, yet many report uncertainty when assessing for and managing suicidal risk. The Collaborative Assessment and Management of suicidal thoughts and behaviors [Collaborative Assessment and Management of Suicidality (CAMS)] is an evidence-based, suicide-focused intervention that has been adapted into a single session [CAMS–Brief Intervention (CAMS-BI)]. Objective: This study tested the use of CAMS-BI with youth who are suicidal and presenting to a pediatric ED. Methods: Participants (aged 12 to 21 y; n = 20) were approached in the ED and completed distress measures before and after CAMS-BI. Following standard discharge timelines was prioritized. Results: Analyses supported CAMS-BI’s feasibility for ED youth populations, given the observed low rate of intervention refusal (8.7%) and high completion rate (87%). Participation in the study did not delay ED discharge times. Youth receiving CAMS-BI reported significantly lower distress postintervention, d = 0.45. Three-month follow-up indicated reductions in ED-return rates (0%) compared with youth who did not receive the intervention (15%), and strong patient engagement with outpatient treatment following CAMS-BI was notable (88% attended follow-up appointment). Conclusions: This pilot study provides evidence for CAMS-BI’s feasibility for youth in fast-paced ED settings and its clinical value to quickly decrease distress. Future directions include larger, more rigorous replications to fine-tune CAMS-BI implementation into ED workflows.

Developing clear, adaptable, and engaging methodologies is critical for advancing the understanding and prevention of self-harm and suicide. This paper presents a review of the development, application and adaptation of the Card Sort Task for Self-Harm (CaTS), a structured, interactive tool designed to map individual pathways to self-harm. Grounded in psychological theory and co-developed with input from people with lived experience, CaTS uses 117 evidence-informed cards representing thoughts, feelings, events, behaviours, and support-related factors. Participants place these cards along a timeline spanning the period before and after a self-harm episode, enabling the identification of both risk and protective factors as well as the sequencing of relevant experiences. The inclusion of blank cards supports personalisation, ensuring the tool remains sensitive to diverse experiences. Unlike traditional psychometric measures, CaTS emphasises holistic understanding and temporal patterning. Since its initial application, CaTS has been adapted for use with varied populations, delivery formats, and research settings. This paper outlines the conception and evolution of CaTS, highlighting the tool’s potential for clinical, research and participatory applications, and utility in training and public engagement. By offering a flexible, person-centred approach, CaTS advances inclusive and nuanced exploration of self-harm processes, offering a novel way to explore often-overlooked, complex temporal dynamics.

Replies to comments by Paniagua (see record 2027-90077-005) on the original article by Jobes and Barnett (see record 2024-78987-001). The quality of research on psychological interventions for suicide risk and for the use of medications alone and in conjunction with psychological interventions is discussed. Risks associated with medication treatment and benefits of psychological interventions are considered. The need to address the underlying causes of suicidality is emphasized with thoughtful attention to relying on the strongest possible research evidence available today to optimally treat suicidal risk to decrease suffering and help save lives. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Introduction: The Collaborative Assessment of Suicidality (CAMS) is an effective clinical framework to treat suicidal thoughts and behaviours. CAMS employs the Suicide Status Form (SSF) to monitor suicide risk factors across sessions. The first six items (termed the SSF Core Assessment) include psychological pain, stress, agitation, hopelessness, self‐hate and self‐reported overall behavioural risk for suicide. The first five are theoretically derived risk factors. While CAMS employs session‐by‐session tracking, no research has investigated how the five risk factors vary together and concurrently and prospectively predict self‐perceived suicide risk when assessed via ambulatory assessment. Methods: Undergraduates ( n = 52) with past‐2‐week suicidal ideation completed 5 ambulatory assessment surveys of the SSF Core Assessment variables daily over 10 days. Descriptive and variability statistics were used to describe the core assessment constructs. Multilevel models were used to examine how the first five items predicted overall behavioural risk of suicide. Results: Each of the SSF Core Assessment variables demonstrated variability over the study period, with stress exhibiting the greatest and overall risk the lowest variability. Self‐hate and hopelessness concurrently predicted self‐reported overall risk for suicide within the same model. Only self‐hate and agitation were significantly prospectively predictive of overall behavioural risk, even after controlling for suicidal ideation. Conclusions: This is the first study to provide insight into the short‐term variability and predictive capabilities of the SSF Core Assessment constructs. Each construct varies considerably over short time scales, suggesting that more frequent monitoring of these constructs may be an important consideration within future CAMS treatment research.

Background: Suicidal ideation is increasing among university students. Despite growing demand for services, university counseling centers (UCCs) face limited resources to meet the complex needs of students who are suicidal. Objective: The Comprehensive Adaptive Multisite Prevention of University Student Suicide (CAMPUS) Trial evaluates 4 treatment sequences within UCCs to develop evidence-based treatment guidelines. Methods: The CAMPUS Trial consists of a feasibility study followed by a sequential multiple-assignment randomized trial (SMART). The original CAMPUS protocol was modified during the COVID-19 pandemic to accommodate new UCC tele–mental health services, including remote treatment, assessments, and monitoring. A smaller-scale feasibility study was conducted to (1) evaluate implementation of hybrid telehealth and in-person interventions and (2) fine-tune online procedures. Following the feasibility study, university students (aged 18-25 years) seeking UCC services with moderate to severe suicidal ideation will enroll in the CAMPUS Trial. Student participants are randomly assigned to 1 of 4 treatment sequences with 2 stages of intervention. In stage 1, students receive 4 to 6 weeks of either (1) a suicide-focused treatment—Collaborative Assessment and Management of Suicidality—or (2) enhanced treatment as usual. Treatment responders enter the maintenance phase. In stage 2, nonresponders are rerandomized for an additional 1 to 8 weeks of (1) Collaborative Assessment and Management of Suicidality or (2) an intensive skills-based treatment—dialectical behavior therapy for UCC settings. UCC counselors will enroll in the CAMPUS Trial to complete measures about their experience working with students who are suicidal. CAMPUS Trial administration includes representation from all sites to facilitate cross-site coordination and an advisory board of stakeholders from all UCCs to facilitate treatment implementation. Results: Student participant recruitment began on October 25, 2022, and ended on May 16, 2024. As of November 2024, data collection for the SMART was ongoing with active study participants. Data collection was completed in November 2024, and as of April 2025, data analysis is underway. Full results will be available in 2025. Conclusions: The CAMPUS Trial offers a model for future SMARTs for the treatment of suicidal thoughts or behaviors (or both) across various settings. The results will inform treatment guidelines for students presenting with suicidality at UCCs. Trial Registration: ClinicalTrials.gov NCT04707066; http://clinicaltrials.gov/ct2/show/NCT04707066 International Registered Report Identifier (IRRID): DERR1-10.2196/68441

Suicide is a major public and mental health problem in the United States and around the world. According to recent survey research, there were 16,600,000 American adults and adolescents in 2022 who reported having serious thoughts of suicide (Substance Abuse and Mental Health Services Administration, 2023), which underscores a profound need for effective clinical care for people who are suicidal. Yet there is evidence that clinical providers may avoid patients who are suicidal (out of fear and perceived concerns about malpractice liability) and that too many rely on interventions (i.e., inpatient hospitalization and medications) that have little to no evidence for decreasing suicidal ideation and behavior (and may even increase risk). Fortunately, there is an emerging and robust evidence-based clinical literature on suicide-related assessment, acute clinical stabilization, and the actual treatment of suicide risk through psychological interventions supported by replicated randomized controlled trials. Considering the pervasiveness of suicidality, the life versus death implications, and the availability of proven approaches, it is argued that providers should embrace evidence-based practices for suicidal risk as their best possible risk management strategy. Such an embrace is entirely consistent with expert recommendations as well as professional and ethical standards. Finally, a call to action is made with a series of specific recommendations to help psychologists (and other disciplines) use evidence-based, suicide-specific, approaches to help decrease suicide-related suffering and deaths. It is argued that doing so has now become both an ethical and professional imperative. Given the challenge of this issue, it is also simply the right thing to do. (PsycInfo Database Record (c) 2025 APA, all rights reserved).