AFS – Aftercare Focus Study: An RCT of CAMS vs Enhanced Usual Aftercare following Inpatient Admission

At a glance

Principal Investigator(s): Kate Comtois
Research Team:
Participating Agencies: UW Medicine
Research Setting: Aftercare at the Harborview Aftercare Research Clinic following emergency and inpatient admission


The Aftercare Focus Study is a randomized clinical trial of standard care Next Day Appointments (NDAs) alone vs. standard care NDAs using the Collaborative Assessment and Management of Suicidality (CAMS) framework. Pilot data for inpatients recruited at Harborview Medical Center in Seattle showed a significant benefit of CAMS in resolving suicidality quickly and preventing relapse over one year.


  • Participants were 150 individuals who attempted suicide some time in their life and were admitted to a hospital or ER following a suicide-related crisis. 75 participants in the experimental condition received adherent CAMS; 75 participants received standard care. Participants in both conditions improved from baseline to 12 months but CAMS was generally not superior to standard care for the primary outcomes.
  • In this trial, a small but significant improvement was found in probability of suicidal ideation at 3 months favoring standard care and amount of suicidal ideation at 12 months favoring CAMS. There was no difference on suicidal behavior.
  • A micro-costing analysis found CAMS was less expensive and more cost-effective and cost-beneficial compared to treatment as usual in this study, replicating a previous finding in the OWL study.


  • Comtois, K. A., Hendricks, K. E., DeCou, C. R., Chalker, S. A., Kerbrat, A. H., Crumlish, J., Huppert, T. K., & Jobes, D. (2023). Reducing short term suicide risk after hospitalization: A randomized controlled trial of the Collaborative Assessment and Management of Suicidality. Journal of Affective Disorders, 320, 656–666.