In my lab, we watch dozens of videos of clinicians participating in five randomized controlled trials (RCTs) investigating the effectiveness of the "Collaborative Assessment and Management of Suicidality" (CAMS) developed in the SPL (Jobes, 2023). Among the ongoing RCTs, I have some observations to share from two particular multisite RCTs that are funded by the National Institute of Mental Health (NIMH).

The first one is a study of college students who are suicidal and seeking counseling center care at the University of Oregon, the University of Nevada-Reno, Duke University, and Rutgers University (Blalock et al., 2025). The second is a “CAMS-4Teens” RCT investigating adolescents who are suicidal in Seattle, Washington and Columbus, Ohio (Adrian et al., 2023). Our deep immersion in these trials, providing adherence coding and feedback to clinicians, along with holding weekly case consultation calls with study providers, offers some interesting observations about contemporary teenagers and college students today.

While there are always exceptions, I am aware of a distinct subgroup of youth who are clearly attached to the concept of suicide. They think about it, they fantasize about it, they interact with other like-minded youth on social media about it, and within their treatment, they talk about it a lot. But here is the thing—based on 43 years of clinical and research experience, I often do not detect a genuine desire to actually die by their own hand in these youth. Among the patients I am describing, there is no suicide attempt history, plans for suicide are unformed and vague, and they are generally ambivalent about actually dying. And yet, these patient remain steadfast in their

© Psychology Today