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Johansson BA, Holmström E, Westling S, Eberhard S, Rask O. Implementation of Brief Admission by Self-Referral in Child and Adolescent Psychiatry in Sweden: Insights from Implementers and Staff. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 21:35. [PMID: 38248500 PMCID: PMC10815113 DOI: 10.3390/ijerph21010035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 12/14/2023] [Accepted: 12/23/2023] [Indexed: 01/23/2024]
Abstract
Brief admission by self-referral, which allows patients to briefly admit themselves to a psychiatric ward, is a crisis intervention designed to reduce suicide and self-harm. This method was introduced in Sweden for adult patients in 2015, achieving high patient satisfaction and good acceptance among staff. In 2018, the method was adapted and implemented in pediatric psychiatry. The present study comprehensively describes the multifaceted strategies for implementing brief admissions, including planning, education, financing, restructuring, quality management, and policy implementation and reform. It also includes staff's opinions of the practice of brief admissions for young people. Neither of these topics has been addressed in the existing literature. During the study period (April 2018-April 2021), 63 brief admission contracts were established. The number of new contracts increased exponentially (12.7%) per quarter (p < 0.05), and staff satisfaction with both the implementation and its benefits for unstable patients was high. Brief admission by self-referral can be successfully implemented in pediatric psychiatry and appears to be a functional crisis management method for adolescents.
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Affiliation(s)
- Björn Axel Johansson
- Region Skåne, Psychiatry, Habilitation & Aid, Child and Adolescent Psychiatry, Regional Inpatient Care, Emergency Unit, 20502 Malmö, Sweden; (E.H.); (S.E.); (O.R.)
- Department of Clinical Sciences Lund, Division of Child & Adolescent Psychiatry, Lund University, 22100 Lund, Sweden
| | - Eva Holmström
- Region Skåne, Psychiatry, Habilitation & Aid, Child and Adolescent Psychiatry, Regional Inpatient Care, Emergency Unit, 20502 Malmö, Sweden; (E.H.); (S.E.); (O.R.)
| | - Sofie Westling
- Department of Clinical Sciences, Malmö, Psychiatry, Lund University, 22100 Lund, Sweden;
- Office for Psychiatry and Habilitation, Psychiatric Clinic Lund, Region Skåne, 22185 Lund, Sweden
| | - Sophia Eberhard
- Region Skåne, Psychiatry, Habilitation & Aid, Child and Adolescent Psychiatry, Regional Inpatient Care, Emergency Unit, 20502 Malmö, Sweden; (E.H.); (S.E.); (O.R.)
- Department of Clinical Sciences Lund, Division of Child & Adolescent Psychiatry, Lund University, 22100 Lund, Sweden
| | - Olof Rask
- Region Skåne, Psychiatry, Habilitation & Aid, Child and Adolescent Psychiatry, Regional Inpatient Care, Emergency Unit, 20502 Malmö, Sweden; (E.H.); (S.E.); (O.R.)
- Department of Clinical Sciences Lund, Division of Child & Adolescent Psychiatry, Lund University, 22100 Lund, Sweden
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