Collaborative Assessment And Management Of Suicidality Research Articles

Novel Telehealth Adaptations for Evidence-Based Outpatient Suicide Treatment: Feasibility and Effectiveness of the Crisis Care Program.

Background: Suicide rates in the United States have escalated dramatically over the past 20 years and remain a leading cause of death. Access to evidenced-based care is limited, and telehealth is well-positioned to offer novel care solutions. The Crisis Care program is a suicide-specific treatment program delivered within a national outpatient telehealth setting using a digitally adapted version of the Collaborative Assessment and Management of Suicidality (CAMS) as the framework of care. This study investigates the feasibility and preliminary effectiveness of Crisis Care as scalable suicide-specific treatment model. Methods: Patient engagement, symptom reduction, and care outcomes were examined among a cohort of patients (n = 130) over 16 weeks. The feasibility of implementation was assessed through patient engagement. Clinical outcomes were measured with PHQ-9, GAD-7, and the CAMS SSF-4 rating scales. Results: Over 85% of enrolled patients were approved for Crisis Care at intake, and 83% went on to complete at least four sessions (the minimum required to graduate). All patient subgroups experienced declines in depressive symptoms, anxiety symptoms, suicidal ideation frequency, and suicide-specific risk factors. Conclusions: Results support the feasibility and preliminary effectiveness of Crisis Care as a suicide-specific care solution that can be delivered within a stepped-care model in an outpatient telehealth setting.

Advancing Suicide Intervention Strategies for Teens (ASSIST): study protocol for a multisite randomised controlled trial

IntroductionBrief interventions that reduce suicide risk following youth’s experience with acute care due to suicidality are needed.Methods and analysisThe study will use a three-arm randomised controlled trial designed to test...

Factor Structure and Measurement Invariance of the Suicide Status Form-IV.

The Suicide Status Form-IV (SSF-IV) is the measure used in the Collaborative Assessment and Management of Suicidality (CAMS). The SSF-IV Core Assessment measures various domains of suicide risk. Previous studies established a two-factor solution in small, homogeneous samples; no investigations have assessed measurement invariance. The current investigation sought to replicate previous factor analyses and used measurement invariance to identify differences in the Core Assessment by race and gender. Adults (N = 731) were referred for a CAMS consultation after exhibiting risk for suicide. Confirmatory factor analyses indicated good fit for both one- and two-factor solutions while the two-factor solution is potentially redundant. Configural, metric, and scalar invariance held across race and gender. Ordinal logistic regression models indicated that neither race nor gender significantly moderated the relationship between the Core Assessment total score and clinical outcomes. Findings support a measurement invariant, one-factor solution for the SSF-IV Core Assessment.

The Collaborative Assessment and Management of Suicidality compared to enhanced treatment as usual for inpatients who are suicidal: A randomized controlled trial.

Although use of inpatient crisis hospital intervention for suicide risk is common, the evidence for inpatient treatments that reduce suicidal thoughts and behaviors is remarkably limited. To address this need, this novel feasibility pilot randomized controlled trial compared the use of the Collaborative Assessment and Management of Suicidality (CAMS) to enhanced treatment as usual (E-TAU) within a standard acute inpatient mental health care setting. We hypothesized that CAMS would be more effective than E-TAU in reducing suicidal thoughts and behaviors. As secondary outcomes we also investigated depressive symptoms, general symptom burden, reasons for living, and quality of the therapeutic relationship. All patients were admitted due to acute suicidal thoughts or behaviors. They were randomly assigned to CAMS (n = 43) or E-TAU (n = 45) and assessed at four time points (admission, discharge, 1 month and 5 months after discharge). We used mixed-effects models, effect sizes, and reliable change analyses to compare improvements across and between treatment groups over time. Intent-to-treat analyses of 88 participants [mean age 32.1, SD = 13.5; n = 47 (53%) females] showed that both groups improved over time across all outcome measures with no significant between-group differences in terms of change in suicidal ideation, depression, reasons for living, and distress. However, CAMS showed larger effect sizes across all measures; for treatment completers CAMS patients showed significant improvement in suicidal ideation (p = 0.01) in comparison to control patients. CAMS patients rated the therapeutic relationship significantly better (p = 0.02) than E-TAU patients and were less likely to attempt suicide within 4 weeks after discharge (p = 0.05). CAMS and E-TAU were both effective in reducing suicidal thoughts and symptom distress. Within this feasibility RCT the pattern of results was generally supportive of CAMS suggesting that inpatient use of CAMS is both feasible and promising. However, our preliminary results need further replication within well-powered multi-site randomized controlled trials. DRKS-ID/ICTRP-ID: DRKS00013727. The trial was retrospectively registered in the German Clinical Trials Register, registration code/ DRKS-ID: DRKS00013727 on 12.01.2018 and also in the International Clinical Trials Registry Platform of the World Health Organization (identical registration code).

Reducing short term suicide risk after hospitalization: A randomized controlled trial of the Collaborative Assessment and Management of Suicidality

BackgroundThis study compared the “next day appointment” (NDA) use of the Collaborative Assessment and Management of Suicidality (CAMS) to treatment as usual (TAU) for individuals discharged from the hospital following a suicide-related crisis. We hypothesized that CAMS would significantly reduce suicidal thoughts and behaviors as well as improve psychological distress, quality of life/overall functioning, treatment retention and patient satisfaction. MethodsParticipants were 150 individuals who had at least one lifetime actual, aborted, or interrupted attempt and were admitted following a suicide-related crisis. There were 75 participants in the experimental condition who received adherent CAMS and 75 participants who received TAU. Suicidal thoughts and behaviors, psychological distress, and quality of life/overall functioning were assessed at baseline and at 1, 3, 6, and 12 months post-baseline. Treatment retention and patient satisfaction were assessed at post-treatment. ResultsParticipants in both conditions improved from baseline to 12 months but CAMS was not superior to TAU for the primary outcomes. A small but significant improvement was found in probability of suicidal ideation at 3 months favoring TAU and amount of suicidal ideation at 12 months favoring CAMS. CAMS participants experienced less psychological distress at 12 months compared to baseline. LimitationsThe study was limited by only one research clinic, lower than expected recruitment, and imbalance of suicidal ideation at baseline. Conclusions: All participants improved but CAMS was not more effective than TAU. The NDA clinic was feasible and acceptable to clients and staff in both conditions and future research should investigate its potential benefit.

The Collaborative Assessment and Management of Suicidality (CAMS) stabilization plan for working with patients with suicide risk.

The Collaborative Assessment and Management of Suicidality (CAMS) provides clinicians with an evidence-based suicide-focused therapeutic framework to help patients understand and manage suicidal thoughts and behaviors. A key component in CAMS suicide-focused treatment planning is the development and use of the CAMS Stabilization Plan (CSP). The CSP is used to ensure between-session safety and stability by helping patients learn to cope differently, enabling clinicians to care for suicidal patients on an outpatient basis, and thereby rendering suicidal-oriented coping obsolete. While implementing and maintaining the CSP, clinicians work to identify, target, and treat patient-identified suicidal drivers aimed at lowering the patient's suicide risk. The CSP employs a collaborative, flexible, and problem-focused approach creating a unique dynamic between clinician and patient as they work together to address the patient's suicidal struggle. CAMS allows clinicians to be flexible in their approach to treating suicidal behavior, utilizing techniques and tools they know, while providing them with a unique framework to engage their suicidal patients. Additionally, there is an overt and ongoing emphasis on encouraging patients to cultivate purpose and meaning in their lives with plans, goals, and hope for the future-ultimately leading patients to discover a life worth living, which is the final focus in CAMS-guided care. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The influence of romantic relationships in assessment of suicide risk in U.S. Army Soldiers

ABSTRACT Even though suicide theories highlight the importance of interpersonal connection, little is known about how romantic relationships impact suicide risk among military personal seeking treatment for suicidal thoughts and behaviors. Data were drawn from active-duty U.S. Soldier participants with suicidal ideation engaged in a suicide-focused treatment – the Collaborative Assessment and Management of Suicidality (CAMS). This exploratory study used a mixed-methods approach to examine two aims: (a) frequencies in which romantic relationships were endorsed in the context of the initial the Suicide Status Form (SSF; the multipurpose clinical tool used in CAMS) and (b) if having endorsed romantic relationships were implicated in their suicidal thoughts and self-inflicted injuries regardless of intent (i.e., non-suicidal self-injury and suicide attempts). We found that 76% of participants mentioned a romantic partner in at least one qualitative assessment item on the SSF. More specifically, 22.6% identified their romantic relationship as a reason for living or a reason for dying, and half of those participants indicated that their romantic relationship was both a reason for living and dying. Soldier participants who identified a current romantic relationship problem, were significantly more likely to have made a self-inflicted injury regardless of intent in their lifetime. Overall, suicidal thoughts and behaviors are intertwined with romantic relationship dynamics, and suicide-focused interventions may benefit from directly addressing these relationship issues with active-duty Soldiers.

Costs, benefits, and cost-benefit of Collaborative Assessment and Management of Suicidality versus enhanced treatment as usual.

Suicide rates have been steadily increasing in both the U.S. general population and military, with significant psychological and economic consequences. The purpose of the current study was to examine the economic costs and cost-benefit of the suicide-focused Collaborative Assessment and Management of Suicidality (CAMS) intervention versus enhanced treatment as usual (ETAU) in an active duty military sample using data from a recent randomized controlled trial of CAMS versus ETAU. The full intent-to-treat sample included 148 participants (mean age 26.8 years ± 5.9 SD years, 80% male, 53% White). Using a micro-costing approach, the cost of each condition was calculated at the individual level from a healthcare system perspective. Benefits were estimated at the individual level as cost savings in past-year healthcare expenditures based on direct care reimbursement rates. Cost-benefit was examined in the form of cost-benefit ratios and net benefit. Total costs, benefits, cost-benefit ratios, and net benefit were calculated and analyzed using general linear mixed modeling on multiply imputed datasets. Results indicated that treatment costs did not differ significantly between conditions; however, CAMS was found to produce significantly greater benefit in the form of decreased healthcare expenditures at 6-month follow-up. CAMS also demonstrated significantly greater cost-benefit ratios (i.e., benefit per dollar spent on treatment) and net-benefit (i.e., total benefit less the cost of treatment) at 12-month follow-up. The current study suggests that beyond its clinical effectiveness, CAMS may also convey potential economic advantages over usual care for the treatment of suicidal active duty service members. Our findings demonstrate cost savings in the form of reduced healthcare expenditures, which theoretically represent resources that can be reallocated toward other healthcare system needs, and thus lend support toward the overall value of CAMS.

Developing a tailored implementation action plan for a suicide prevention clinical intervention in an Australian mental health service: A qualitative study using the EPIS framework.

Background: Tailoring implementation strategies to local contexts is a promising approach to supporting implementation and sustainment of evidence-based practices in health settings. While there is increasing research on tailored implementation of mental health interventions, implementation research on suicide prevention interventions is limited. This study aimed to evaluate implementation and subsequently develop a tailored action plan to support sustainment of an evidence-based suicide prevention intervention; Collaborative Assessment and Management of Suicidality (CAMS) in an Australian public mental health service. Methods: Approximately 150 mental health staff working within a regional and remote Local Health District in Australia were trained in CAMS. Semi-structured interviews and focus groups with frontline staff and clinical leaders were conducted to examine barriers and facilitators to using CAMS. Data were analysed using a reflexive thematic analysis approach and mapped to the Exploration, Preparation, Implementation and Sustainment (EPIS) framework and followed by stakeholder engagement to design a tailored implementation action plan based on a 'tailored blueprint' methodology. Results: A total of 22 barriers to implementing CAMS were identified. Based on the perceived impact on implementation fidelity and the feasibility of addressing identified barriers, six barriers were prioritised for addressing through an implementation action plan. These barriers were mapped to evidence-based implementation strategies and, in collaboration with local health district staff, goals and actionable steps for each strategy were generated. This information was combined into a tailored implementation plan to support the sustainable use of CAMS as part of routine care within this mental health service. Conclusions: This study provides an example of a collaborative approach to tailoring strategies for implementation on a large scale. Novel insights were obtained into the challenges of evaluating the implementation process and barriers to implementing an evidence-based suicide prevention treatment approach within a geographically large and varied mental health service in Australia. Plain language abstract: This study outlines the process of using a collaborative stakeholder engagement approach to develop tailored implementation plans. Using the Exploration Preparation Implementation Sustainment Framework, findings identify the barriers to and strategies for implementing a clinical suicide prevention intervention in an Australian community mental health setting. This is the first known study to use an implementation science framework to investigate the implementation of the clinical suicide prevention intervention (Collaborative Assessment and Management of Suicidality) within a community mental health setting. This work highlights the challenges of conducting implementation research in a dynamic public health service.

The effectiveness of the Collaborative Assessment and Management of Suicidality (CAMS) compared to alternative treatment conditions: A meta-analysis.

This meta-analysis aimed to test the efficacy of the Collaborative Assessment and Management of Suicidality (CAMS) intervention against other commonly used interventions for the treatment of suicide ideation and other suicide-related variables. Database, expert, and root and branch searches identified nine empirical studies that directly compared CAMS to other active interventions. A random effects model was used to calculate the effect size differences between the interventions; additionally, moderators of the effect sizes were tested for suicidal ideation. In comparison to alternative interventions, CAMS resulted in significantly lower suicidal ideation (d=0.25) and general distress (d=0.29), significantly higher treatment acceptability (d=0.42), and significantly higher hope/lower hopelessness (d=0.88). No significant differences for suicide attempts, self-harm, other suicide-related correlates, or cost effectiveness were observed. The effect size differences for suicidal ideation were consistent across study types and quality, timing of outcome measurement, and the age and ethnicity of participants; however, the effect sizes favoring CAMS were significantly smaller with active duty military/veteran samples and with male participants. The existing research supports CAMS as a Well Supported intervention for suicidal ideation per Center of Disease Control and Prevention criteria. Limitations and future directions are discussed.

An Archival Study of Suicide Status Form Responses Among Crisis Stabilization Center Consumers

Suicide is a persistent leading cause of death in the United States (U.S.A.). Following a stepped-care approach, Crisis Stabilization Centers have positioned themselves as a viable treatment option for many patients experiencing suicidal crises. These centers are staffed by an array of clinicians with varied professional backgrounds and clinical preferences. Thus, some treatments may hold greater flexibility and potential for broad implementation than others. In various settings, the Collaborative Assessment and Management of Suicidality (CAMS) has served as an effective and flexible therapeutic framework. Research on the Suicide Status Form (SSF)—a central component of the CAMS-based assessment process—has not been previously performed with adults in Crisis Stabilization Center settings in the USA. Aggregate data from a cross section of 61 residential Crisis Stabilization Center consumers who completed SSFs as part of the CAMS-based assessment process were analyzed. Analyses examined self-reported SSF Core Assessment constructs associated with suicidality and self-reported suicide risk. Statistically significant decreases in suicide related SSF Core Assessment construct ratings from initial to outcome time point were observed. There were also statistically significant correlations between change in each individual SSF Core Assessment variable and change in self-reported suicide risk over treatment. Initial SSF Core Assessment ratings together significantly predicted both change in self-reported suicide risk and outcome self-reported suicide risk. These findings highlight the utility of the CAMS approach and SSF Core Assessment variables within USA adult Crisis Stabilization Center consumers experiencing suicidality. Clinical implications and opportunities for future research are discussed.

53.2 CRISIS CARE FOR YOUTH PRESENTING WITH ACUTE BEHAVIORAL HEALTH NEEDS

This clinical presentation offers clinicians an opportunity to understand a short-term crisis consultation clinic approach using the Collaborative Assessment and Management of Suicidality (CAMS) framework for informing treatment in line with Zero Suicide principles.

Educational assessment of a social simulation for MSW students using the CAMS framework

ABSTRACT Approximately 45,000 people die by suicide annually in the United States with over 60% seeking help in the year leading up to their death. Of students receiving suicide-specific training in their degree programs, nearly two-thirds feel inadequately prepared for practice with suicidal clients. This study explores the outcomes of an educational pilot study (N = 29) integrating didactic instruction, readings, role-plays, and simulation for teaching suicide intervention skills. The Collaborative Assessment and Management of Suicidality (CAMS) framework is used as a guideline to develop knowledge, skills, and confidence in working with clients who are suicidal. Repeated measures ANOVA results indicate statistically significant improvements in students’ knowledge and Counseling Self-Estimate Inventory (CSEI) scores overtime (p <.05). Moreover, CSEI and the subscale of dealing with difficult client behaviors showed statistically significant improvements from pre-simulation to post-simulation (p <.05). While an abundance of research exists regarding the use of simulation within medical education, a limited amount of research examines the relevance of simulation within graduate education for helping professionals (e.g., counselors and social workers). These results suggest an added benefit of high-fidelity simulations in the training of helping professionals to develop clinical suicide intervention skills.

Embedding an Evidence-Based Model for Suicide Prevention in the National Health Service: A Service Improvement Initiative.

Despite the improved understanding of the determinants of suicide over recent decades, the mean suicide rate within the United Kingdom (UK) has remained at 10 per 100,000 per annum, with about 28% accessing mental health services in the 12 months prior to death. In this paper, we outlined a novel systems-level approach to tackling this problem through objectively differentiating the level of severity for each suicide risk presentation and providing fast-track pathways to care for all, including life-threatening cases. An additional operational challenge addressed within the proposed model was the saturation of local crisis mental health services with approximately 150 suicidality referrals per month, including non-mental health cases. This paper discussed a service improvement initiative undertaken within a National Health Service (NHS) secondary care mental health provider’s open-access 24/7 crisis and home treatment service. An organisation-wide bespoke “suicide risk triage” system utilising the Collaborative Assessment and Management of Suicidality (CAMS) was implemented across all services. The preliminary impacts on suicidality, suicide rates and service user outcomes were described.

The COVID-19 pandemic and treating suicidal risk: The telepsychotherapy use of CAMS.

The COVID-19 pandemic has created profound challenges for health care systems worldwide. The exponential spread of COVID-19 has forced mental health providers to find new ways of providing mental health services that maintain physical distance and keeps providers and patients at home limiting possible exposure to the deadly virus. The pandemic has thus sparked a sudden interest in providing mental health services via telepsychotherapy (otherwise known as telehealth or telemedicine). Telepsychotherapy care has some inherent challenges that must always be mastered by providers to render effective care. Previous research and professional guidelines understandably note possible concerns about providing telepsychotherapy care to high-risk suicidal patients in a remote location. The coronavirus pandemic now poses all new ethical concerns about the routine practice of having an acutely suicidal patient go to an emergency department and/or admitting such patients to an inpatient psychiatric unit (if the public health goal is to limit the spread of this deadly virus). To this end, this article describes a pandemic-driven effort to rapidly provide support, guidance, and resources to providers around the world to use a suicide-focused and evidence-based intervention called the Collaborative Assessment and Management of Suicidality (CAMS) within a telepsychotherapy modality. Additional suicide-relevant resources are being made available to provide further guidance and support to mental health professionals worldwide. In the midst of a global pandemic, there are emerging ways to help reduce further loss of life to suicide through the medium of telepsychotherapy to provide effective clinical care that is suicide-focused and evidence-based.

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

BackgroundThe 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 are investigating whether CAMS is more effective than Enhanced-Treatment as Usual (E-TAU) in reducing suicidal thoughts as primary outcome variable. We are also investigating depressive symptoms, general symptom relief, and the quality of the therapeutic alliance as secondary outcomes.Methods/DesignThis RCT is designed as a single-center, two-armed, parallel group observer-blinded clinical effectiveness investigation. We are recruiting and randomizing 60 participants with different diagnoses, who are admitted as inpatients because of acute suicidal thoughts or behaviors into the Clinic for Psychiatry and Psychotherapy, Ev. Hospital Bethel in Bielefeld, Germany. The duration of treatment will vary depending on patients’ needs and clinical assessments ranging between 10 and 40 days. Patients are assessed four times, at admission, discharge, 1 month, and 5 months post-discharge. The primary outcome measure is the Beck Scale for Suicide Ideation. Other outcome measures are administered as assessment timepoints including severity of psychiatric symptoms, depression, reasons for living, and therapeutic relationship.DiscussionThis effectiveness study is being conducted on an acute ward in a psychiatric clinic where patients have multiple problems and diagnoses. Treatment is somewhat limited, and therapists have a large caseloads. The results of this study can thus be generalizable to a typical inpatient psychiatric hospital settings.Trial registrationThis clinical trial has been retrospectively registered with the German Clinical Trials Register; registration code/ DRKS-ID: DRKS00013727 (on January 12, 2018). In addition, the study was also registered with the International Clinical Trials Registry Platform of the World Health Organization (identical registration code). Registry Name: „Evaluation von CAMS versus TAU bei suizidalen Patienten – Ein stationärer RCT“.

A Randomized Controlled Trial of the Collaborative Assessment and Management of Suicidality (CAMS) Versus Treatment as Usual (TAU) for Suicidal College Students

This randomized controlled trial compared the Collaborative Assessment and Management of Suicidality (CAMS) and Treatment as Usual (TAU) for suicidal college students within a feasibility trial. Sixty-two suicidal college students were randomized to CAMS (n = 33) or TAU (n = 29). We hypothesized that those receiving CAMS would show more improvement in suicide-related measures, and effects would be moderated by borderline personality disorder (BPD), prior suicide attempts, and age. Both treatment groups showed improvements in all outcome variables; CAMS had a significantly higher impact on depression and suicidal ideation when measured weekly during care and was more likely than TAU to decrease hopelessness among students with fewer BPD features, no suicide attempt history, and older age. Conversely, TAU did better for students with BPD features and history of multiple suicide attempts.

Self-determination theory and the collaborative assessment and management of suicidality

Purpose The collaborative assessment and management of suicidality (CAMS) is a first-encounter suicide-specific brief intervention that motivates suicidal individuals for voluntary treatment engagement and choosing life. How the intervention works, however, has not been theoretically explained. The purpose of this paper is to explain the effectiveness using self-determination theory (SDT). Design/methodology/approach The paper focuses the theoretical examination on the philosophy of care and the clinical procedures of the CAMS suicide intervention. SDT is used as the theoretical lens of the examination. Findings The underlying philosophy of care and the clinical procedures of CAMS enhance the autonomy, relatedness and competence of the client in the first encounter. The paper proposes that fulfilling these basic human needs results in the intervention outcomes of treatment engagement and choosing life for the time being. Research limitations/implications The research is limited to the examination of the documented clinical procedures and philosophy of care. Further research applying SDT to the design and empirical testing of therapeutic interventions for suicide prevention is warranted. Practical implications Clinicians working with suicidal clients need to empathically address suicidal individuals’ motivation to engage in voluntary treatment and reduce controlling and autonomy-thwarting approaches. Social implications Suicidal behaviour is conventionally considered the manifestation of a mental disorder characterized by limited informed decision-making. The success of CAMS points to the contrary. Despite their suffering, many suicidal individuals make informed decisions about treatment with the support of an empathetic clinician. Originality/value CAMS has not previously been theoretically explained. This paper explains the effectiveness of the intervention in engaging suicidal clients in further treatment through SDT.

A Preliminary Precision Treatment Rule for Remission of Suicide Ideation.

There is growing interest in the development of composite precision treatment rules (PTRs) to guide the selection of the treatments most likely to be helpful for individual patients. We present here the results of an effort to develop a preliminary PTR for Collaborative Assessment and Management of Suicidality (CAMS) relative to enhanced-care as usual based on secondary analysis of the Operation Worth Living (OWL) randomized controlled trial. The outcome of interest is eliminating suicide ideation (SI) within 3months of initiating treatment. A state-of-the-art ensemble machine learning method was used to develop the PTR among the n=148 U.S. Soldiers (predominately male and White, age range 18-48) OWL patients. We estimated that CAMS was the better treatment for 77.8% of patients and that treatment assignment according to the PTR would result in a 13.6% (95% CI: 0.9%-26.3%) increase in 3-month SI remission compared to random treatment assignment. Although promising, results are limited by the small sample size, restrictive baseline assessment, and inability to evaluate effects on suicidal behaviors or disaggregate based on history of suicidal behaviors. Replication is needed in larger samples with comprehensive baseline assessments, longer-term follow-ups, and more extensive outcomes.

Child and adolescent suicide: contributing risk factors and new evidence-based interventions

ABSTRACTOur goal of this special issue is to detail and describe the current epidemiology of suicide among children and adolescents, as well as highlight important risk factors and evidence-based treatment options. To accomplish this, our issue is organized in two major sections: (1) contributing factors to the emergence of child and adolescent suicide, and (2) evidence-based treatment of child and adolescent suicide. Within the issue, authors discuss risk factors of anxiety, sleep problems, child sexual abuse, and violence perpetration, and conclude with treatment considerations including the Collaborative Assessment and Management of Suicidality (CAMS) and safety planning. Across studies, it is clear that there is an urgent need to better understand and effectively treat child and adolescent suicide.