Inclusion Criteria:  patients with any DSM-5 diagnosis aged 18 years and above; admitted to CAMH with suicidality and a baseline BSI score of > 6; capable and willing to give informed consent; anticipated length of admission is greater than 5 days; deemed suitable by the primary team to take part in a psychotherapeutic intervention as part of standard care  Capacity to consent will be evaluated by the research staff performing the informed consent process. It will be assessed as the participant's ability to understand and appreciate the risks and benefits of taking part in the proposed study.  Exclusion Criteria:  presence of psychiatric symptoms that interfere with the ability to complete the d-DBT Concurrent treatment with ECT or MST