Barriers and Facilitators to Implementing the Collaborative Assessment and Management of Suicidality (CAMS)

Abstract Objective Suicide is a major public health problem, with suicidal ideation experienced by about 16.5 million Americans. The Collaborative Assessment and Management of Suicidality (CAMS) has been empirically proven to reduce suicidal ideation across various randomized controlled trials in outpatient and inpatient settings. Implementing CAMS likely requires specific adaptations to address setting-specific barriers and promote facilitators. A recent paper exists identifying barriers and facilitators for suicide prevention interventions in general but no published paper to date has done this for CAMS specifically. Methods This scoping review of PsycINFO, EBSCOhost, and PubMed examined CAMS papers describing barriers, facilitators, and adaptations in various settings. Data was mapped onto Consolidated Framework for Implementation Research (CFIR) domains using a data table. Results The 23 included CAMS implementation papers spanned various populations, e.g. teens, and settings, from short-term crisis to inpatient, in the United States, Europe, and Australia. Common barriers were in the inner setting (available resources and leadership engagement) and outer setting (patient needs/resources). Common facilitators were in the intervention characteristics (adaptability and relative advantage). Conclusion CAMS was perceived to be uniquely adaptable to various settings and populations. Teams with more leadership support and time had an easier time implementing CAMS. Compared to other treatments for suicidal ideation, brief cognitive behavioral therapy and dialectical behavioral therapy, the flexibility of CAMS was perceived to be an advantage. Future research should examine the usability and effectiveness of CAMS in inpatient settings and with patients with borderline personality disorder.