A Digital Dialectical Behaviour Therapy Intervention for Acute Suicidality in Psychiatric Inpatients: A Feasibility Randomised Controlled Study: Intervention numérique en thérapie comportementale dialectique en cas de suicidabilité aiguë de patients hospitalisés en psychiatrie : Étude de faisabilité contrôlée à répartition aléatoire

OBJECTIVE: To evaluate the feasibility and preliminary efficacy of a digital dialectical behaviour therapy (d-DBT) skills intervention in suicidal psychiatric inpatients. METHODS: A parallel arm, assessor-blinded, randomized controlled trial (RCT) was conducted to compare d-DBT to standard care among psychiatric inpatients. Participants included adults admitted for suicidality (i.e., suicidal ideation or suicide attempt). The intervention group received a d-DBT intervention encompassing 5 online modules completed over 5 to 10 days, covering mindfulness, emotion regulation, and distress tolerance skills. Participants received an initial orientation but no formal therapy sessions. Daily check-ins were available for technical-related queries. Feasibility outcomes included recruitment, adherence (≥3 modules completed), retention, and acceptability (client satisfaction questionnaire-8). Efficacy outcomes included suicidality (Columbia-Suicide Severity Rating Scale [C-SSRS] total score), psychological distress (K10), emotion regulation (Difficulties in Emotion Regulation Scale-16 [DERS-16]), and clinical global impression (CGI). Linear regression models analysed group differences. RESULTS: A total of 65 participants were recruited, of which 42 were randomized, with high d-DBT adherence rates in the intervention arm (75%). The d-DBT intervention demonstrated significant reductions in C-SSRS scores (Cohen's -1.0) compared to standard of care. No significant group differences were observed in K10, DERS-16, or CGI. High acceptability and satisfaction were reported among participants randomized to d-DBT. Challenges and limitations included maintaining follow-up postdischarge and the small sample size. CONCLUSION: d-DBT is feasible to implement through an RCT and may reduce suicidality and improve mental health among psychiatric inpatients. The study highlights the importance of developing accessible, evidence-based interventions for this population. Future research should focus on long-term efficacy and expanding the intervention's appeal and accessibility.