(PS13-66) Using the Collaborative Assessment and Management of Suicidality-suicide Status Form to Predict Outcomes Following Treatment in an Outpatient Crisis Stabilization Clinic

The Collaborative Assessment and Management of Suicidality (CAMS; Jobes, 2006) is a suicide-specific treatment framework that seeks to identify and treat suicidal drivers in a client-centered manner. The CAMS Suicide-Status Form (SSF) measures six core factors of suicide risk including: Psychological Pain, Stress, Agitation, Hopelessness, Self-Hate, and self-rated Suicide Risk. Use of the SSF allows for the development of individualized treatment plans while tracking intensity of suicide risk across treatment. Data from the current study comes from the Seattle Children’s Hospital Crisis Care Clinic (CCC). The CCC is a brief, outpatient stabilization program that uses the CAMS-SSF to facilitate individual and family therapy for up to four visits before transitioning to longer-term care. Patients’ caregivers were contacted one month following discharge to collect information on various treatment outcomes including youth engagement in suicidal or self-harm behavior and mental health services. Youth were included in analyses if they attended at least two clinic visits and had at least two SSFs (initial and outcome forms). The final sample consisted of 227 youth (M_age = 14.9, range 10-20 years). Approximately 94% of youth endorsed suicidal ideation within the month prior to treatment; 62% reported a lifetime history of suicide attempts. Youth demonstrated a significant decrease in the intensity of all core constructs across treatment, including self-rated suicide risk. Regression analyses indicated that higher Psychological Pain (B[SE] = .17[.07], p = .02) at the start of treatment predicted less change in Suicide Risk across treatment. Higher initial Suicide Risk (B[SE] = -.63[.07], p < .001) predicted more reduction in risk across treatment. Higher Psychological Pain (B[SE] = .16[.07], p = .02), Agitation (B[SE] = .09[.05], p = .048), and Suicide Risk (B[SE] = .37[.07], p < .001) at the start of treatment was associated with higher Suicide Risk at the final session. Increases in Hopelessness (B[SE] = .19[.04], p < .001) and Self-Hate (B[SE] = .18[.05], p < .001) during treatment predicted higher Suicide Risk at the final session. Neither change in ratings across treatment nor ratings at the final session predicted crisis service use in the month following CCC discharge. Additionally, change in ratings across treatment did not predict self-injurious behavior following discharge. However, final session Psychological Pain rating did predict self-injurious behavior in the month following discharge (B[SE] = .82[.40], p = .04, OR = 2.28). Results of the current study demonstrate utility of the CAMS SSF to help inform clinical decision-making and highlights the need to focus intervention on factors associated with suicide risk and self-injurious behavior.