Young people at risk of suicide. ecological momentary assessment and digital safety planning in a case series

Background Young people remain at high risk of recurrent suicidal behavior following a suicidal crisis, highlighting the need for innovative strategies to support post-crisis care. Digital interventions, including Ecological Momentary Assessment (EMA) and digital Safety Planning, may facilitate continuous monitoring and personalized support during this vulnerable period, describing the feasibility, acceptability, and clinical trajectories associated with EMA and digital Safety Planning across heterogeneous intervention exposures. Methods We present a case series of four participants enrolled in the RCTs SmartCrisis-Teen and SmartCrisis 2.0 cohorts following a recent suicidal crisis. Clinical evolution, engagement with the digital platform, EMA data, use of the digital Safety Plan, and user satisfaction are described throughout follow-up. Results Clinical trajectories were heterogeneous. One participant experienced a suicide attempt during follow-up, whereas no further suicide attempts were recorded in the remaining participants. All participants remained engaged in specialized mental health care. EMA captured short-term fluctuations in suicidal ideation, sleep, and emotional functioning, although these patterns did not consistently coincide with clinical events. Conclusions This case series provides preliminary evidence supporting the feasibility and acceptability of combining EMA with a digital Safety Plan as an adjunct to standard psychiatric care following a suicidal crisis. Although clinical effectiveness cannot be established from this descriptive case series, these findings support the potential clinical utility of digital monitoring and safety planning and justify further evaluation in larger prospective controlled studies.