Evaluating the impact of embedding the Collaborative Assessment and Management of Suicidality (CAMS) intervention into the NHS, including service user and clinician outcomes for its utility

This thesis encapsulates the methodological evaluation of a bespoke clinical risk service improvement initiative within a National Health Service (NHS) mental health organisation. The specific operational components of this initiative were informed by preceding review chapters of pertinent literature for life-threatening behaviours, self-harm and suicidality, including the efficacy of existing interventions. The rationale for the final model, which embedded both triage and treatment components, is provided. The model allowed clinicians to undertake objectively informed and individualised treatment decisions (triage process) for all presenting service users (n=2176), including access to the evidence-based Collaborative Assessment and Management of Suicidality (CAMS) intervention, in instances of life-threatening behaviour (n=52). The hypotheses were supported in that the triage process resulted, at six-month follow-up, in a lower number of Crisis and Liaison Psychiatry contacts, reduced psychiatric admissions and length of hospital stay, whilst increasing mental health appointment attendance. A comparison of the CAMS cohort with a propensity-score matched historical control group supported the hypotheses that the CAMS intervention reduced future Crisis presentations, although was no different for other mental health service inputs besides the need for increased Home Treatment Team contacts. Acceptability of the CAMS intervention was explored using an approach informed by Interpretative Phenomenological Analysis (IPA) of individual semi-structured interviews with services users (n=8) and clinicians (n=10), with key themes indicating sensitivity to service user needs and improved clinician confidence. The implications of the findings are discussed and recommendations made for future research within the field. Finally, the proposal of a series of considerations for researchers and stakeholders working within the NHS and suicide prevention are postulated.

Name dc:type.qualificationname

PhD

Level dc:type.qualificationlevel

Doctoral

Grantor dc:publisher.institution

The University of Hull

Year dc:date.issued

2021

Author dc:creator

• Brown, Sophie Rebecca

• Psychology

Language dc:language

en

Identifier

oai:hull-repository.worktribe.com:4192963

OAI identifier oai:identifier

oai:hull-repository.worktribe.com:4192963