Effect of Brief Admission to Hospital by Self-referral for Individuals Who Self-harm and Are at Risk of Suicide

Westling, Sofie; Daukantaité, Daiva; Liljedahl, Sophie; Oh, Youngha; Westrin, Åsa; Flyckt, Lena; Helleman, Marjolein

doi:10.1001/jamanetworkopen.2019.5463

Cited by 37 publications

(64 citation statements)

References 31 publications

(37 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…One hundred twenty-five participants with current episodes of self-harm and/or recurrent suicidal behavior, as well as at least three diagnostic criteria for borderline personality disorder (BPD), were recruited from four psychiatric inpatient clinics in Skåne, Sweden, for a project evaluating the effects of Brief Admission to the hospital by self-referral (37). All participants were undergoing treatment at a psychiatric outpatient clinic throughout the study.…”

Section: Methods Participantsmentioning

confidence: 99%

One-Year Consistency in Lifetime Frequency Estimates and Functions of Non-Suicidal Self-Injury in a Clinical Sample

et al. 2020

Self Cite

View full text Add to dashboard Cite

Non-suicidal self-injury (NSSI), the direct, deliberate destruction of one's own bodily tissue in the absence of an intent to die, is frequently used for evaluating treatment in clinical care. One instrument for assessing NSSI is the Inventory of Statements About Self-Injury (ISAS). The ISAS is a self-rating measure examining the lifetime frequencies of NSSI behaviors and further exploring NSSI functions. The study aimed to examine the consistency of self-reported lifetime NSSI frequencies and functions (via the ISAS) in a clinical sample of individuals with current self-harm and/or recurrent suicidal behaviors over one year. Fifty-two individuals (84.6% women) completed the ISAS three times over 1 year. We found relatively good test-retest stability for most NSSI behaviors and functions, but the correlation coefficients and frequencies of NSSI behaviors varied substantially. Approximately, 50% of participants reported lower lifetime frequencies of NSSI behaviors at the later time points, with approximately 20% reporting a significant reduction in their lifetime frequencies over one year. This unexpected finding raises concerns about the accuracy of reporting lifetime NSSI frequencies among individuals with multiple psychiatric diagnoses and extensive NSSI behaviors across their lives. Further research is needed to determine more reliable ways of collecting data on the lifetime frequency of NSSI in clinical samples and the accuracy of lifetime NSSI frequency estimates in general.

show abstract

Section: Methods Participantsmentioning

confidence: 99%

One-Year Consistency in Lifetime Frequency Estimates and Functions of Non-Suicidal Self-Injury in a Clinical Sample

et al. 2020

Self Cite

View full text Add to dashboard Cite

show abstract

“…Self‐admission has been offered in Norway and the Netherlands for over a decade as a tool in the treatment of longstanding mental illness such as schizophrenia, bipolar disorder, and borderline personality disorder (Strand & von Hausswolff‐Juhlin, 2015). Similar programs have been introduced in Sweden (Eckerström et al, 2019; Strand, Gustafsson, Bulik, & von Hausswolff‐Juhlin, 2015; Westling et al, 2019) and Denmark (Thomsen et al, 2018). The self‐admission model has previously been described in detail in this journal (Strand et al, 2015; Strand, Bulik, von Hausswolff‐Juhlin, & Gustafsson, 2017).…”

Section: Introductionmentioning

confidence: 96%

Self‐admission to inpatient treatment in anorexia nervosa: Impact on healthcare utilization, eating disorder morbidity, and quality of life

Strand

Bulik

Gustafsson

et al. 2020

Intl J Eating Disorders

View full text Add to dashboard Cite

Objective: Little evidence exists concerning the optimal model of inpatient care for patients with longstanding anorexia nervosa (AN). Self-admission has been developed as a treatment tool whereby patients with a history of high healthcare utilization are invited to decide for themselves when brief admission is warranted. The aim of this study was to evaluate the impact of a self-admission program on healthcare utilization, eating disorder morbidity, health-related quality of life (HRQoL), and sick leave for patients with AN. Method: In this cohort study, 29 participants with AN in a Swedish self-admission program were compared to 113 patients with longstanding illness but low previous utilization of inpatient treatment, matched based on age, illness duration, and bodymass index (BMI). Data on healthcare utilization, eating disorder morbidity, and sick leave were obtained from national population and eating disorder quality registers. Results: Participants displayed a >50% reduction in time spent hospitalized at 12month follow-up, compared to nonsignificant changes in the comparison group. A sensitivity analysis comparing participants to a moderate-utilization comparison subgroup strengthened this observation. In contrast, the approach did not affect participants' BMI or eating disorder morbidity. Regarding HRQoL, mixed results were observed. In terms of sick leave, a beneficial but nonsignificant pattern was seen for participants. Discussion: These findings indicate that self-admission is a viable and helpful tool within a recovery model framework, even though it does not lead to symptom remission. In its proper context, self-admission could potentially transform healthcare from crisis-driven to pre-emptive, and promote autonomy for severely ill patients.

show abstract

“…The goal of such a method is to increase the autonomy of patients with severe psychiatric profiles by promoting early help‐seeking behaviour and thereby reducing the more traditional coercive interventions, which in turn, reduces the total time spent in inpatient care. The first randomized clinical trial regarding BA for patients with BDP studied effects after 12 months (Westling et al, 2019). The trial showed a reduction in days with compulsory admission and non‐suicidal self‐injuries, and also greater improvements in the mobility domain of daily life functioning compared to the control group (Westling et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

“…The first randomized clinical trial regarding BA for patients with BDP studied effects after 12 months (Westling et al, 2019). The trial showed a reduction in days with compulsory admission and non‐suicidal self‐injuries, and also greater improvements in the mobility domain of daily life functioning compared to the control group (Westling et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

Brief admission for patients with emotional instability and self‐harm: A qualitative analysis of patients’ experiences during crisis

Eckerström

Flyckt

Carlborg

et al. 2020

Int J Mental Health Nurs

Self Cite

View full text Add to dashboard Cite

Previous studies report that individuals diagnosed with borderline personality disorder have been met by negative attitudes from healthcare professionals and their care needs have often been neglected during hospitalizations. When symptoms of emotional instability are combined with self-harm, the resulting crisis often becomes difficult to handle for patients and healthcare professionals. To meet their care needs during these crises, an intervention called 'brief admission' (BA) has been developed. The purpose of BA is to provide a timeout, in situations of increased stress and threat, in order to foster self-management in a safe environment. In the present study, we explored the following research questions: What are patients' experiences with BA? What do patients consider to be the key components of BA? What improvements are considered relevant by patients? A qualitative design was employed, and 15 patients (13 females, 2 males; mean age 38.5 AE 12.9, range 20-67 years) were interviewed using a semi-structured interview guide. Thematic analyses were performed, which yielded four themes related to the patients' experiences: 'a timeout when life is tough', 'it is comforting to know that help exists', 'encouraged to take personal responsibility', and 'it is helpful to see the problems from a different perspective'. Four themes also described the key components: 'a clear treatment plan', 'a smooth admission procedure', 'a friendly and welcoming approach from the staff', and 'daily conversations'. Lastly, three themes described areas for improvements: 'feeling guilty about seeking BA', 'room occupancy issues', and 'differences in staff's competence'. Collectively, the findings indicate that BA constructively supports patients with emotional instability and self-harm during a period of crisis.

show abstract

Effect of Brief Admission to Hospital by Self-referral for Individuals Who Self-harm and Are at Risk of Suicide

Cited by 37 publications

References 31 publications

One-Year Consistency in Lifetime Frequency Estimates and Functions of Non-Suicidal Self-Injury in a Clinical Sample

One-Year Consistency in Lifetime Frequency Estimates and Functions of Non-Suicidal Self-Injury in a Clinical Sample

Self‐admission to inpatient treatment in anorexia nervosa: Impact on healthcare utilization, eating disorder morbidity, and quality of life

Brief admission for patients with emotional instability and self‐harm: A qualitative analysis of patients’ experiences during crisis

Contact Info

Product

Resources

About