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Peer-reviewedCC BY 4.0Frontiers in Psychiatry

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

  • Álvaro Loewen1
  • Felipe M. Herrmann2,3
  • Inmaculada Peñuelas-Calvo4,5,6,7
  • Laura Mata-Iturralde1
  • Enrique Baca-García1,3,7,8,9,10,11
  • Philippe Courtet12
  • Alejandro Porras-Segovia3,11,13,14
14 affiliations
  1. 1Department of Psychiatry, Hospital Universitario Fundación Jiménez Díaz
  2. 2Department of Psychology, Harvard University
  3. 3Health Research Institute Fundación Jiménez Díaz
  4. 4Department of Child and Adolescent Psychiatry, Hospital Universitario 12 de Octubre
  5. 5Health Research Institute Hospital 12 de Octubre (i+12 Institute)
  6. 6Department of Psychiatry, Universidad Complutense de Madrid
  7. 7CIBERSAM-ISCIII (Biomedical Research Networking Centre for Mental Health/Carlos III Health Institute)
  8. 8Department of Psychiatry, Universidad Autónoma de Madrid
  9. 9Department of Psychiatry, Hospital Universitario General de Villalba, Collado Villalba
  10. 10Department of Psychiatry, Hospital Universitario Infanta Elena, Valdemoro
  11. 11Department of Psychiatry, University Hospital Rey Juan Carlos, Móstoles
  12. 12Department of Emergency Psychiatry and Acute Care, Centre Hospitalier Universitaire Montpellier, University of Montpellier, Institute Genomics Functional (IGF), CNRS, INSERM
  13. 13Department of Health Sciences and Neurosciences, University Carlos III of Madrid
  14. 14Institute Genomics Functional (IGF), University of Montpellier, CNRS, INSERM
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Abstract

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.

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Cite

BibTeXRIS
BibTeX
@article{loewen2026young,
  title = {{Young people at risk of suicide. ecological momentary assessment and digital safety planning in a case series}},
  author = {Álvaro Loewen and Felipe M. Herrmann and Inmaculada Peñuelas-Calvo and Laura Mata-Iturralde and Enrique Baca-García and Philippe Courtet and Alejandro Porras-Segovia},
  journal = {Frontiers in Psychiatry},
  year = {2026},
  month = nov,
  doi = {10.3389/fpsyt.2026.1983683},
  url = {https://www.frontiersin.org/articles/10.3389/fpsyt.2026.1983683/full},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Young people at risk of suicide. ecological momentary assessment and digital safety planning in a case series
AU  - Álvaro Loewen
AU  - Felipe M. Herrmann
AU  - Inmaculada Peñuelas-Calvo
AU  - Laura Mata-Iturralde
AU  - Enrique Baca-García
AU  - Philippe Courtet
AU  - Alejandro Porras-Segovia
PY  - 2026
DA  - 2026/11/03
JO  - Frontiers in Psychiatry
DO  - 10.3389/fpsyt.2026.1983683
UR  - https://www.frontiersin.org/articles/10.3389/fpsyt.2026.1983683/full
AB  - 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.
SN  - 1664-0640
ER  -