The CARMS project is recruiting again and the Trial Protocol paper has been published! | News and Events

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The CARMS project is recruiting again and the Trial Protocol paper has been published!

Led by members of the Patient Safety Research Unit (PSRU), the CARMS project is investigating how effective a new suicide-prevention psychological therapy for people with psychosis is in NHS services.

The project has been recruiting service users with non-affective psychosis and recent suicidal experiences in GMMH, Lancashire Care and Pennine Care for 3 and a half years now. The CARMS Trial protocol has now been published online, so you can read more about the study design, the psychological intervention (Cognitive Behavioural Suicide Prevention therapy for psychosis), questionnaire and interview measures, along with planned data analysis. 

Key strengths of the CARMS project are: 

  • The CARMS project has been co-produced with a patient Find out more on our website public involvement group, who named themselves the CARMers. People who have lived experience of suicidality and severe mental health problems are and have been essential to all stages of the project. 

  • The CARMS CBSPp has a theoretical and empirical evidence base. It is based on a psychological model (Schematic Appraisal Model of Suicide[1]) and theories of what may lead people with psychosis to feel suicidal or attempt suicide. The therapy has also been found to be feasible and acceptable across several populations who are at high risk of suicide, e.g. people with psychosis [2], male prisoners [3] and people on psychiatric inpatient wards [4]. 

  • It is suicide focussed, personalised, and formulation driven, which involves developing an understanding of the person’s suicidal experiences in the context of their individual circumstances, relationships and life events, along with the beliefs they have formed about them. 

  • It aims to advance ‘understanding of the psychological mechanisms underlying suicidal thoughts and behaviours’  ͥ 

  • Qualitative work is being conducted as part of the project to explore i. ‘psychological mechanisms’, ii. ‘barriers and facilitators to providing the CARMS trial intervention in the “real world”’, iii. ‘implementation challenges and solutions’, iv. both positive and negative experiences of the therapy, and v. ‘experiences of taking part in suicide research’ [5] 

After 3 months of being paused to recruitment due to the COVID-19 pandemic, the CARMS project has been given the go-ahead to re-start recruitment and is accepting referrals again. Find out how to refer/get involved on the CARMS website:  

The CARMS Trial protocol is free to access here: 


[1] Johnson J, Gooding P, Tarrier N. Suicide risk in schizophrenia: explanatory models and clinical implications, The Schematic Appraisal Model of Suicide (SAMS). Psychol Psychother. 2008;81(Pt 1):55-77. doi:10.1348/147608307X244996 

[2] Tarrier N, Kelly J, Maqsood S, et al. The cognitive behavioural prevention of suicide in psychosis: a clinical trial. Schizophr Res. 2014;156(2-3):204-210. doi:10.1016/j.schres.2014.04.029 

[3] Pratt, D, Tarrier, N, Dunn, G, et al. Cognitive–behavioural suicide prevention for male prisoners: A pilot randomized controlled trial. Psychological Medicine, 2015;45(16): 3441-3451. doi:10.1017/S0033291715001348 

[4] Haddock, G, Pratt, D, Gooding, P, et al. Feasibility and acceptability of suicide prevention therapy on acute psychiatric wards: Randomised controlled trial. BJPsych Open, 2019;5(1): E14. doi:10.1192/bjo.2018.85 

[5] Gooding, P.A., Pratt, D., Awenat, Y. et al. A psychological intervention for suicide applied to non-affective psychosis: the CARMS (Cognitive AppRoaches to coMbatting Suicidality) randomised controlled trial protocol. BMC Psychiatry 20, 306 (2020). 

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