Collaborative Assessment and Management of Suicidality (CAMS) compared to Enhanced Treatment as Usual (E-TAU) for suicidal patients in an inpatient setting: Study protocol for a randomized controlled trial

Abstract Background: The Collaborative Assessment and Management of Suicidality (CAMS) is a therapeutic framework that has been shown to reduce suicidal ideation and overall symptom distress. CAMS has not been previously evaluated in a standard acute inpatient mental health care setting with only short treatment times for suicidal patients. In this randomized controlled trial (RCT) we investigate, if CAMS is more effective than Enhanced-Treatment as Usual (E-TAU) in reducing suicidal thoughts and behaviors. As secondary outcomes we are also investigating depressive symptoms, symptom relief in general, and quality of the therapeutic relationship. Methods/design: The trial is designed as a single-center, two-armed, parallel group observer-blinded randomized clinical effectiveness trial. We aim to recruit and randomize 60 participants with different diagnoses, who are admitted as inpatients due to acute suicidal thoughts or behavior in the Clinic of Psychiatry and Psychotherapy, Ev. Hospital Bethel in Bielefeld, Germany. The duration of treatment will vary depending on patients’ needs and clinical assessments between 10 and a maximum of 40 days. Patients are assessed at 4 time points (admission, discharge, 1 month, and 5 months after discharge). The primary outcome measure is the Beck Scale for Suicide Ideation. Other outcome measures are included, such as severity of psychiatric symptoms, depression, reasons for living, and the therapeutic relationship. Discussion: This effectiveness study is being conducted on an acute ward in a psychiatric clinic where patients have multiple problems and diagnoses. Treatment times are rather short and therapists have a high workload. The results of this study can be generalized to a typical hospital setting and similar results should be expected if CAMS is implemented in other psychiatric systems.