mHealth-supported Skills Training for Alcohol-Related Suicidality

Suicide is a high priority public health problem and an increasingly prevalent alcohol-related consequence. One-third of people who die by suicide consume alcohol at hazardous rates in the year preceding death. Most people in an acute suicide crisis who present for treatment are admitted to acute psychiatric hospitalization. Yet, the 30-day period following discharge from hospitalization is by far the riskiest period for another suicide crisis. The specific aim for this project is to use a successive cohort design to iteratively develop an intervention called mHealth-supported Skills Training for Alcohol-Related Suicidality (mSTARS). The study team will adapt and iteratively refine a cognitive-behavioral skills training intervention in emotion regulation to be administered in an acute care setting and paired with a post-discharge mHealth app that encourages application of these skills to real life. Two cohorts of five participants each will be enrolled in the project. Participants will complete mSTARS, an intervention that combines inpatient skills training and the mHealth telephone app. Upon completion of the 30-day period, participants will complete self-report measures and participate in an interview designed to evaluate their experience with the mSTARS intervention.

Inclusion Criteria: 1. Age 18+ 2. hospitalized for suicide crisis at Duke BHIP 3. an AUDIT-C score indicating hazardous past-month drinking (4 for men; 3 for women) + a 90-day calendar timeline follow-back (TLFB) indicating a minimum of 3 heavy drinking days per week on average (per NIAAA standards) 4. owns a smart phone 5. fluent in English. Exclusion Criteria: 1. current psychotic or mania symptoms indicated by the MINI Neuropsychiatric Interview 6.0.(MINI) 2. receiving ECT at the time of hospitalization, which could inhibit learning 3. engaged in weekly outpatient psychotherapy 4. discharging to another high level of psychiatric care.