Please select the eligibility criteria that correspond to the clinical trial below.
Title: Pilot Study of a Smart Phone Assisted Problem Solving Therapy for Men Who Have Presented With Intentional Self-harm to Emergency Departments
Brief Summary: To refine a novel intervention using a combination of a smart phone application with best practice psychotherapy for men who have presented to hospital with intentional self-harm. The outcome will be change in baseline of scores on a depression rating scale the PHQ-9 at six weeks. Moreover, the investigators will ask participants about the acceptability of the intervention and the acceptability of using routine data sources as outcome measures. This will inform methods of recruitment for the larger cluster randomized controlled trial and the creation of a treatment manual.


Options:
A: Inclusion Criteria:

* Participant is male;
* Participant is 18 years of age or older;
* Participant has presented via Emergency Department to The Ottawa Hospital General and Civic Campuses with intentional self-harm;
* Participant is willing to return to the The Ottawa Hospital General Campus for follow-up appointments;
* Participant is willing to consent to participate in the study.

Exclusion Criteria:

* Participant is unable to read or understand English;
* Participant has cognitive impairments that render them incapable of using a smart phone;
* Participant does not have a smart phone and/or a smart phone with a data plan;
* Participants who in the opinion of the investigator will be unlikely to commit to a three month long study.
B: Inclusion Criteria:

* Current psychiatric inpatients
* Possess an active email account
* Informed consent
* Active duty military, Veteran, Retiree, National Guard or Reserves status

Exclusion Criteria:

* Not competent to consent
* Adverse behavioral problems
* The primary psychiatric nurse or attending psychiatrist considers that study to be clinically inappropriate
* Currently under arrest/incarceration
* Involuntary committed for psychiatric care status
C: Inclusion Criteria:

* Meets DSM-IV criteria for Borderline Personality Disorder.
* Has had at least 2 self-harm episodes (either suicidal or non-suicidal) in the past 5 years, including at least 1 in the past 8 weeks.
* Proficient in English
* Provides informed consent to participate in the study.
* Absence of 8 or more standard weeks of DBT in the past year (individual and group therapy components).
* has had either Ontario Health Insurance Plan (OHIP) coverage or BC Medical Services Plan (MSP) health insurance for 1 year or more
* Absence of a pending criminal court case or charges.
* Has been a resident of Ontario or British Columbia for all of the past 12 months, at least.
* Lives in the Greater Toronto Area/Greater Vancouver Area

Exclusion Criteria:

* Meets the DSM-IV criteria for bipolar disorder I, dementia, or a psychotic disorder other than psychotic disorder NOS
* IQ less than 70
* Chronic or serious physical health problem requiring hospitalization within the next year (e.g., cancer)
* Plans to move to a province other than Ontario or BC in the next 2 years.
D: Inclusion Criteria:

1. Veteran service member
2. Recently admitted to an inpatient psychiatry unit at the VAMC site following a suicide attempt
3. 18 or more years of age
4. Consents to participate in baseline and follow-up interviews and gives permission to review records for previous year and subsequent year.
5. Consents to randomization and participation in TMBI + follow-up or Care as Usual
6. Consents to audio recording in order for PI to conduct adherence rating

Exclusion Criteria:

1. Significant psychosis, cognitive, or other problems that prevent participant from understanding the study procedures or renders them unable to provide informed consent (suggesting that psychosocial therapeutic care is contra-indicated)
2. Judicially-ordered to treatment (e.g., subsequent to domestic violence) such that participation in study procedures could not be considered voluntary and participant is not free to drop out without significant negative consequences.

Answer: A