(PS2-B37) Examining the Immediate Effects of Session One of the Collaborative Assessment and Management of Suicidality (CAMS) on Patient Readiness to Live

Evidence suggests that risk for an individual outpatient suicide attempt after psychiatric inpatient care is 300 times that of the national average. Thus, inpatient psychiatric care is a critical contact point for individuals experiencing suicidal thoughts and behaviors (STB). The Zero-Suicide framework provides empirically informed scaffolding for improving suicide prevention within inpatient psychiatry via the Assess, Intervene, and Monitor (AIM-SP) model. However, available evidence suggests that extant assessment and intervention do not typically target STB as the primary outcome and are not optimized for the time-limited nature of inpatient psychiatric care. The Collaborative Assessment and Management of Suicidality (CAMS) fits well within the AIM-SP model and could be leveraged as a single session intervention (SSI) within psychiatric inpatient care. The efficacy thereof has yet to be tested, however. 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 interventions and may be of interest to inpatient care providers. The purpose of this study is to test the immediate efficacy of CAMS as a SSI for psychiatric inpatients experiencing STB. Accordingly, this study examined the immediate effect of CAMS Session 1 on change in SUDS and readiness to continue living. Thus far, (n = 50) patients admitted to acute psychiatric inpatient care with a variety of presenting concerns have been referred and consented for participation in CAMS Session 1. Patients were referred by their primary psychiatrist if they exhibited a non-zero risk for outpatient suicidal behavior (e.g., suicide attempt, passive/active suicidal ideation). Chi-square analysis demonstrated that a significantly greater (X² = 18.76, p < .001) proportion of patients (62%, n = 31) reported a reduction in SUDS from pre- to post-session. Dependent samples t-test showed that, on average (M = 9.7, SD = 19.04), patients reported a statistically significant reduction in their SUDS, t(49) = 3.602, p < .001, with a medium effect, d = 0.508, from pre- (M = 35.9, SD = 19.04) to post session (M = 26.2, SD = 21.35). Chi-square analysis showed that the significant majority of patients (X² = 20.44, p < .001) reported no change (58%, n = 29) in their Living Ladder scores from pre- to post-session. However, dependent samples t-test showed that, on average (M = 0.5, SD = 1.62), patients reported a statistically significant improvement in readiness to continue living, t(49) = 2.179, p < .05, with a small effect, d = 0.308, from pre- (M = 6.52, SD = 2.06) to post-session (M = 7.02, SD = 1.75). The foregoing results suggest that CAMS Session 1 may be effective at reducing subjective distress and increasing a patient’s motivation to engage in behaviors that make their life worth living (e.g., using their Safety Plan, engaging in outpatient mental healthcare). Data collection is ongoing with an average of 3 participants consenting to participate each week with an expected N of ~150 by November 2022. Such increased power will facilitate planned primary outcome contrasts (e.g., comparison of LL and SUDS post-intervention status [increase, no change, decrease] by race, gender, and suicide attempt history).