A Stepped Care Approach to Clinical Suicide Prevention

Jobes, David A.
Gregorian, Mariam J.
Colborn, Victoria A.

Department of Psychology, The Catholic University of America

David A. Jobes would like to disclose the following potential conflicts: grant funding for clinical trial research from the Department of Defense, the American Foundation for Suicide Prevention, and the National Institute of Mental Health; book royalties from American Psychological Association Press and Guilford Press; co-owner of CAMS-care, LLC (a clinical training/consulting company). We thank our research collaborators over the past 30 years who have made the work described throughout this article possible. Special appreciation goes out to members—past and present—of The Catholic University of America Suicide Prevention Lab.

David A. Jobes, Department of Psychology, The Catholic University of America, 314 O’Boyle Hall, Washington, DC 20064 [email protected]

Received May 30, 2017

revised November 12, 2017

Accepted November 19, 2017

Psychological Services 15(3):p 243-250, August 2018. | DOI: 10.1037/ser0000229

Despite the enormous humanitarian and economic toll of suicide, mental health systems of care are largely underprepared to work effectively with suicidal individuals and suicide is a leading “Sentinel Event” in U.S. health care settings (). In response to these concerns, a recent policy initiative called “Zero Suicide” has advocated a systems-level response to the suicidal risk within health care and this policy initiative is yielding positive results (). Along these lines, a “stepped care” approach developed by has been adapted and used within the Zero Suicide curriculum as a model for systems-level care that is suicide-specific, evidence-based, least-restrictive, and cost-effective. The Collaborative Assessment and Management of Suicidality (CAMS) is an example of one suicide-specific evidence-based clinical intervention that can be adapted and used across the full range of stepped care service settings (). This article describes various applications and uses of CAMS at all service levels and highlights CAMS-related innovations. It is argued that psychological services are uniquely poised to make a major difference in clinical suicide prevention through a systems-level approach using evidence-based care such as CAMS.