How to Access and Complete the CAMS Suicide Status Form (SSF-4)

The CAMS Suicide Status Form is a multipurpose clinical document, developed by David Jobes, that guides mental health clinicians and their patients through a structured, collaborative assessment and treatment of suicidal risk. It spans up to eight pages across three phases of care — an initial session, interim tracking sessions, and a final outcome session — and doubles as the medical record for each phase.¹ Clinician and patient complete it side by side, which makes it one of the few risk assessment tools designed to be fully transparent to the person being assessed.

How to Get the Form

The SSF is not freely downloadable. Guilford Press holds the copyright, and clinicians can obtain it two ways.

The first is buying Jobes’s book, Managing Suicidal Risk: A Collaborative Approach, 3rd Edition. Ownership grants limited permission to photocopy the form or use a web-based version. The paperback is $49.00, the hardcover $74.00, and the e-book $49.00.²

The second is through a CAMS-care account, which also provides access to translated versions on a case-by-case basis for properly trained clinicians.¹

If your practice uses an electronic health record, the SSF has been licensed for integration into Epic (requires SLG 7812088 and QAN 6762881), Netsmart, NextGen, Oracle, Meditech, Valant, and several other platforms. When the system supports it, the form populates directly in the patient chart.¹

Session 1: The Initial Assessment

The first CAMS session uses pages 1 through 4. Before starting, the clinician arranges the seating so both parties can view the form at the same time. That side-by-side setup is central to the framework: it shifts the encounter from a traditional interview into a joint exploration of what is driving the patient’s suicidal thinking. The patient completes their own ratings while the clinician records observations in parallel sections.³

Section A: Patient Self-Report (Page 1)

The patient rates five core experiences on a scale from 1 (low) to 5 (high):⁴

Psychological pain — internal hurt, anguish, or misery, distinct from physical pain or general stress.
Stress — the feeling of being pressured or overwhelmed by external circumstances.
Agitation — emotional urgency or a felt need to take action, not simple irritation.
Hopelessness — the expectation that nothing will improve regardless of effort.
Self-hate — a general dislike of oneself, low self-esteem, or lack of self-respect.

The patient then rates the wish to live and the wish to die on separate 0-to-8 scales. These two items are scored independently. A patient can rate both high, which signals dangerous ambivalence, or rate the wish to die far above the wish to live, which points to more acute risk.⁴

Section A also asks the patient to identify the “one thing” that would make them no longer feel suicidal, which often becomes a treatment anchor, and to describe their reasons for living and reasons for dying in their own words. The numbers give a snapshot; the written answers tend to show what to treat.

Section B: Clinician Assessment (Page 2)

While the patient works on Section A, or immediately after, the clinician completes Section B. It captures the clinical risk profile through a structured checklist:

Suicidal ideation: presence, frequency, and duration.
Suicide plan: whether one exists, and if so the when, where, how, and whether the patient has access to the intended means.
Preparation and rehearsal: any steps taken toward acting on the plan or behaviors practiced in advance.
History: single or multiple prior attempts, in the patient’s own words.
Contributing factors: impulsivity, substance use, significant losses, relationship problems, feeling like a burden, health or pain issues, sleep disturbance, legal or financial stress, and shame.

Each item takes a yes/no plus a brief description. The clinician documents in the patient’s view. When patients see their risk factors written out plainly, the conversation often opens up in ways a behind-the-clipboard interview does not.⁴

Section C, the treatment plan, sits within this same portion of the form. Clinician and patient jointly identify problem descriptions, goals, objectives, and interventions. Treatment targets flow directly from whatever scored highest in Section A and whatever emerged as most pressing in Section B.

The Stabilization Plan (Page 3)

Page 3 is the most immediately consequential part of the form. The CAMS Stabilization Plan addresses what the patient will do between sessions when distress escalates, and it starts with lethal means restriction.⁵

The clinician works with the patient to identify accessible methods and agrees on realistic steps to limit access: handing over a stockpile of medication to a trusted person, installing a cable lock on a firearm for the duration of treatment. If a patient strongly resists means restriction, hospitalization may become the only safe option.⁵

From there, the Stabilization Plan moves through several more components:¹

Coping strategies the patient can use when suicidal urges intensify.
Emergency contacts, including crisis lines, reachable at any hour.
Social supports who can reduce interpersonal isolation.
Barriers to treatment, with a plan to address each one.

Both parties sign the plan. The patient has helped design their own safety net, and the signed record documents that means restriction and crisis planning were addressed.

Section D: Post-Session Evaluation (Page 4)

After the patient leaves, the clinician completes Section D alone. It includes a mental status exam covering alertness, orientation, mood, affect, thought continuity and content, speech, memory, and reality testing, plus behavioral observations, diagnostic impressions using DSM/ICD codes, and an overall risk rating of low, moderate, or high.⁴

The overall risk rating ties to the wish-to-live and wish-to-die scores. Low risk corresponds to a stronger wish to live and more reasons for living. Moderate risk reflects genuine ambivalence. High risk indicates a predominant wish to die with more reasons for dying. Case notes and additional clinical reasoning go here as well.

Interim Tracking Sessions (Pages 5–6)

Every session after the first opens with the patient re-rating the same five core items on the same 1-to-5 scales. Interim sessions add a sixth: overall risk of suicide, scaled from 1 (“extremely low risk, will not kill self”) to 5 (“extremely high risk, will kill self”). The patient also reports whether they had suicidal thoughts or feelings in the past week, whether they managed those thoughts effectively, and whether any suicidal behavior occurred.⁶

The bulk of the session then treats the drivers identified during Session 1. If hopelessness scored a 5 and self-hate a 4, those are the targets. Clinicians use whatever evidence-based interventions fit the driver: cognitive behavioral techniques for distorted thinking, dialectical behavior approaches for emotional regulation, mindfulness for agitation. At the end, the clinician updates Section B and reviews whether the Stabilization Plan needs changes.¹

If scores stay high or worsen, the treatment plan has to change. The tracking form makes stagnation impossible to ignore. You cannot chart the same elevated numbers session after session without revising your approach.

Resolution and the Outcome Session (Pages 7–8)

CAMS uses measurable criteria to decide when the suicide-focused phase can end. Resolution requires three consecutive sessions in which the patient’s overall suicide risk rating falls below 3, the patient reports no suicidal behavior in the past week, and the patient effectively managed any suicidal thoughts or feelings that arose.⁷ Without three consecutive sessions meeting all three criteria, tracking continues.

Once resolution is met, clinician and patient complete the Outcome/Disposition SSF together. The patient reflects on what parts of treatment helped and what they learned that could protect them if suicidal feelings return. The clinician documents the disposition: continued outpatient therapy for non-suicide-related issues, mutual termination, referral to another provider, or in rarer cases inpatient hospitalization or the patient’s unilateral decision to stop treatment.⁷

Both parties sign. Ending the CAMS phase does not mean the patient is “cured.” It means they can manage suicidal thoughts and feelings reliably enough to no longer need a suicide-specific frame. Many patients continue therapy afterward for depression, trauma, or other underlying conditions.

Training to Use the Form Properly

The book alone is not enough. CAMS has two credentialing levels.

CAMS Trained is the foundational level, requiring 10 hours: the CAMS Foundational Video Course, reading Managing Suicidal Risk, 3rd Edition, an interactive role-play training day, and four consultation calls. The full package starts at $414.⁸

CAMS Certified builds on the foundational level. Certification requires passing the test in the book ($42, with 6 CE credits available) and completing a two-hour competency review featuring a one-on-one role-play with a senior CAMS consultant ($500).⁸

Most clinicians say the framework clicks during the role-play. Reading about side-by-side seating and collaborative assessment is one thing; doing it with a standardized patient who pushes back on means restriction is another. The consultation calls also let clinicians troubleshoot real cases under supervision.

Why the Documentation Matters

The SSF is the medical record for each CAMS session. In a malpractice action following a patient suicide, the question is whether the clinician met the standard of care, defined case by case by what a similarly trained provider would have done in the same situation. A completed SSF creates a paper trail showing systematic risk assessment, treatment planned around identified drivers, means restriction, a signed stabilization plan, and longitudinal tracking with documented adjustments when scores didn’t improve. Sparse notes with vague language like “patient denies SI” leave a clinician exposed if a negative outcome leads to litigation.⁹

1
CAMS-care. The Suicide Status Form
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Guilford Press. Managing Suicidal Risk Third Edition A Collaborative Approach
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CAMS-care. CAMS-care The CAMS Framework
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Psychotherapy Matters. CAMS Suicide Status Form-4 SSF-4 Initial Session
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CAMS-care. Lethal Means Safety and CAMS
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Pacific Clinics. CAMS Suicide Status Form-4 SSF-4 Tracking Update Interim Session
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Pacific Clinics. CAMS Suicide Status Form-4 SSF-4 Outcome Disposition Final Session
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CAMS-Care. Suicide Prevention Training and Certification
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CAMS-care. Malpractice Liability Related to Suicidal Risk How to Decrease the Risk