Brief Admission by Self-referral for Individuals With Self-harm: Effects on Compulsory Care

Region Skane

Status: Enrolling

Conditions: Suicide, Attempted; Borderline Personality Disorder; Self-harm; Emergency Psychiatric; Hospitalizations Psychiatric; Self-injury; Suicide

Treatments: Other: Brief Admission by self-referral (BA)

Study type: Observational

Funder types: Other

Identifiers

NCT06406972

2022-02307-01

Details and patient eligibility

About

Brief Admission by self-referral (BA) is a standardized treatment model, providing patient-controlled and person-centered care. It was developed to reduce self-harm and compulsory care by promoting autonomy. Randomized clinical trials have not yielded significant between group differences with respect to inpatient care, including compulsory care. The major difficulty in evaluating BA is preventing the control group from cross-contamination, as in the implementation process of BA, all physicians, all inpatient and outpatient staff as well as managers need to be informed and undergo basic education regarding the intervention. As BA addresses a prevalent and frustrating issue in psychiatric health care, there is considerable risk that the approach leaks to the control group, reducing the possibility to detect between-group differences. In the current study this will be addressed through a register-based approach, comparing similar clinics, implementing BA at different timepoints over time. Individuals with traits of borderline personality disorder will be included and comparisons will be made with respect to compulsory care, voluntary inpatient care and mortality.

Enrollment: 7,000 estimated patients

Sex: All

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Living in the uptake area of Lund, Linköping, Helsingborg or Norrköping
• Age 18-65 years at the time of inclusion
• Admitted to hospital either diagnosed with ICD-10 diagnosis BPD F60.3, or admitted at least twice with Intentional self-harm X60-83 in combination with one of more of the following diagnoses ADHD (F90.0-F90.X), Bipolar disorder type 2, (F31.8W, F318A-F, F31.0, F31.8-9, F31.8W) or Autism, Atypical autism, Aspergers syndrome (F84.0, F84.1, F84.5) or Mild intellectual disability (F70.0-F70.9).

Exclusion criteria

• not fulfilling inclusion criteria

Trial design

7,000 participants in 12 patient groups

Lund 2010-09-15-2015-09-14

Description:

Lund, before implementation of Brief Admission by self-referral

Lund 2015-09-15-2020-09-14

Description:

Lund, after implementation of Brief Admission by self-referral in Lund, before implementation of Brief Admission by self-referral in Linköping

Treatment:

Other: Brief Admission by self-referral (BA)

Lund 2020-09-15-2025-09-14

Description:

Lund, after implementation of Brief Admission by self-referral in Lund and in Linköping

Treatment:

Other: Brief Admission by self-referral (BA)

Linköping 2010-09-15-2015-09-14

Description:

Linköping before implementation of Brief Admission by self-referral

Linköping 2015-09-15-2020-09-14

Description:

Linköping after implementation of Brief Admission by self-referral in Lund, before implementation of Brief Admission by self-referral in Linköping

Linköping 2020-09-15-2025-09-14

Description:

Linköping after implementation of Brief Admission by self-referral in Lund and in Linköping

Treatment:

Other: Brief Admission by self-referral (BA)

Helsingborg 2014-02-15-2017-02-14

Description:

Helsingborg before implementation of Brief Admission by self-referral

Helsingborg 2017-02-15-2020-02-14

Description:

Helsingborg after implementation of Brief Admission by self-referral in Helsingborg, before implementation of Brief Admission by self-referral in Norrköping

Treatment:

Other: Brief Admission by self-referral (BA)

Helsingborg 2020-02-15-2023-02-14

Description:

Helsingborg after implementation of Brief Admission by self-referral in Helsingborg and in Norrköping

Treatment:

Other: Brief Admission by self-referral (BA)

Norrköping 2014-02-15-2017-02-14

Description:

Norrköping before implementation of Brief Admission by self-referral

Norrköping 2017-02-15-2020-02-14

Description:

Norrköping after implementation of Brief Admission by self-referral in Helsingborg, before implementation of Brief Admission by self-referral in Norrköping

Norrköping 2020-02-15-2023-02-14

Description:

Norrköping after implementation of Brief Admission by self-referral in Helsingborg and in Norrköping

Treatment:

Other: Brief Admission by self-referral (BA)