CAMS Relational Agent System (CAMS-RAS) for Suicide Prevention

An 18-item psychometrically sound self-report measure, the Suicide Cognitions Scale (SCS) assesses suicidal schemas. The score is found by summing the items for a total ranging from 18 to 90 with higher scores indicating worse outcomes. The scale is administered to patient participants at four time-points during Phase II (summative) ED RCT and Telehealth RCT to assess change over time.

A nine-item self-report measure that assesses recent depressive symptoms and has excellent sensitivity (.77 to .86) and specificity (.78 to .95) in detecting major depression. The Patient Health Questionnaire-9 (PHQ-9) total score is found by summing the answers and ranges from 0 to 27. Higher scores indicate more severe symptoms. It is administered to patient participants at four time-points during Phase II (summative).

A face-valid self-report measure developed by Dr. Dimeff and used in other clinical trials to assess frequency of skills use, perceived helpfulness of skill, and self-efficacy in using them. It is administered to patient participants at four time-points during Phase II (summative).

An eight-item measure frequently used in clinical trials, modified for this study to focus on patient participants' emergency department experience. The Client Satisfaction Questionnaire (CSQ) is scored by summing the individual items to produce a range of 8 to 32, with higher scores indicating greater satisfaction. It is administered to patient participants at four time-points during Phase II (summative).

(Previously titled "Research Participation Questionnaire") A four-item self-report scale (min: 1 (low); max 10 (high)) modified for this study to measure emotional distress and self-efficacy in coping with suicidality. It is administered to patient participants at each assessment point during Phase II (summative) ED RCT and Telehealth RCT.

A 21-item self-report measure frequently used in clinical trials, used to measure emotional states of depression, anxiety, and stress. The DASS-21 contains three subscales with seven items each. Subscale totals are obtained by summing the seven item scores and multiplying by two to produce a range from 0 to 42, with higher scores indicating higher severity. It is administered to patient participants at three time-points during the Phase II (summative) Telehealth RCT.

This 17-item self-report measure is designed to assess a participant's capacity to cope effectively with their suicidal thoughts. Each item is rated on five point Likert scale from 0 (Strongly Disagree) to 4 (Strongly Agree). It is administered to patient participants at each assessment time-points during Phase II (summative) ED RCT and Telehealth RCT.

A six-item self-report measure assessing frequency of engagement in suicidal or self-injurious behaviors as well as frequency of seeking assistance from emergency room, professional, or crisis line for suicidal or self-injurious behaviors in the past three months. It is administered to patient participants at three time-points during the Phase II (summative) Telehealth RCT.

A four-item self-report scale assessing suicide ideation and attempt over the lifetime and past year; threat of suicide attempt; likelihood of suicidality in the future. Items are summed producing a total ranging from 3 to 18, with higher scores indicating higher severity. It is administered at three time-points during the Phase II (summative)Telehealth RCT.

An eight-item self-report measure to assess patient satisfaction with the care they received, perception of provider, and readiness to maintain safety. Higher scores indicate higher levels of satisfaction. It is administered to patient participants at three time-points during Phase II (summative) Telehealth RCT.

A 12-item self-report measure assessing the usability and satisfaction of the JAH mobile app. Higher scores indicate higher satisfaction and usability. It is administered to patient participants at three time-points during Phase II (summative) Telehealth RCT.

A brief face-valid, self-report measure that the PI derived from the System Usability Scale and has been successfully used in previous studies. Items are rated on a 5-point Likert Scale (1=poor; 3=good; 5=excellent). Open-ended questions are included to better understand what was most and least helpful with respect to each category and also measures users' acceptance. This scale is only administered during Phase I, formative usability and acceptability testing. It is administered directly after participants complete their interaction with the technology during their one-time participation.

A face-valid self-report measure that will be adapted by the Principal Investigators to assess patient preparedness for clinical interview, patient distress, provider confidence in suicide risk assessment and helpfulness of clinical support tool. Expected date of development: February, 2019. It is administered to provider participants at four time-points during Phase II (summative).

A 14-item self-report measure to assess optimism and hope. A total score is obtained by summing ratings on a 4-point Likert scale (1=definitely true; 4=definitely not true) with scores ranging from a total of 14 (low) to 56 (high). It is administered to patient participants at each assessment time-point during Phase II (summative) ED RCT and Telehealth RCT.

A semi-structured interview to ask about and understand the user's likes, dislikes, and preferences. The semi-structured interview will be conducted for purposes of evaluating the usability of the technology rather than collecting any quantitative data for data analyses. It is administered in Phase I, formative usability and acceptability testing. Participants are asked to complete the semi-structured interview conducted by the research assistant after interacting with the technology.