Brief Admission for Adolescents Who Self-harm

Suicide, Attempted Clinical Trial

Official title:

Brief Admission by Self-referral for Adolescents Who Self-harm, at Risk for Suicide. A Qualitative Study to Optimise and Standardise the Intervention

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT04962373
• Other study ID #: 2020-01840
• Status: Recruiting
• Start date: September 1, 2020
• Est. completion date: December 31, 2025

Study information

• Verified date: January 2024
• Source: Region Skane
• Contact: Sofie Westling, MD PhD
• Phone: +46735626099
• Email: sofie.westling[@]med.lu.se
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

There is still no consensus on how to manage suicidal behavior in youth with recurrent self-harm at times when the risk for suicide is imminent (1). Brief Admission (BA) has evolved as a promising crisis intervention for adults with self-harm (2). The characteristics of BA is different from other types of admission, being focused on prevention through increased autonomy and self-care, based on structured and voluntary brief self-referrals to hospital (3). As a result of a randomized controlled trial, BA is since January 2019, continuously offered to adults with self-harm at risk for suicide in Skåne (4). Parallel to this clinical trial, the method has been adapted to work in a psychiatric setting for adolescents. At present 24 adolescents have access to the method in Skåne. Clinical experiences from staff are promising, however, the lived experiences have not been collected in a standardized way. The aim of the present study is to gather information on how BA in its present, standardized form works for adolescents, their loved ones and staff working at the ward providing BA. This will be done through semi-structured interviews with: 1. Adolescents using BA and their loved ones 2. Staff working at the ward providing BA. Data will be analyzed with qualitative analysis (5, 6). The ultimate aim is to use these results to optimize the current standardized version of BA for adolescents in order to test in a randomized clinical trial.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 75
• Est. completion date: December 31, 2025
• Est. primary completion date: December 31, 2025
• Accepts healthy volunteers: No
• Gender: All
• Age group: 13 Years to 100 Years

Eligibility

Sample 1:

Inclusion Criteria:

• Adolescents with an active BA contract
• At least 13 years of age.
• Able to consent to study participation through written and oral information.
• Consent from caregivers
• Given consent to participate

Exclusion Criteria:

• Below the age of 13. Sample 2:

Inclusion Criteria:

• Parents to adolescents with an active BA contract
• At least 18 years of age.
• Able to consent to study participation through written and oral information.
• Given consent to participate

Exclusion Criteria:

• None Sample 3:

Inclusion Criteria:

• Staff working with adolescents with an active BA contract
• At least 18 years of age.
• Able to consent to study participation through written and oral information.
• Given consent to participate

Exclusion Criteria:

• None

Related Conditions & MeSH terms

• Non-Suicidal Self Injury
• Self-Harm, Deliberate
• Self-Injurious Behavior
• Suicidal
• Suicide
• Suicide, Attempted

Intervention

Other:
• Semi-structured interviews
Each participant will attend a 30-60 minute semi-structured interview conducted by the CI

Locations

Country	Name	City	State
Sweden	Psykiatri och habilitering, Region Skåne	Lund	Skåne

Sponsors (2)

Lead Sponsor	Collaborator
Region Skane	Lund University

Country where clinical trial is conducted

Sweden, 

References & Publications (7)

Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today. 2004 Feb;24(2):105-12. doi: 10.1016/j.nedt.2003.10.001. — View Citation

Helleman M, Lundh LG, Liljedahl SI, Daukantaite D, Westling S. Individuals' experiences with brief admission during the implementation of the brief admission skane RCT, a qualitative study. Nord J Psychiatry. 2018 Jul;72(5):380-386. doi: 10.1080/08039488.2018.1467966. Epub 2018 Apr 27. — View Citation

Lindkvist RM, Landgren K, Liljedahl SI, Daukantaite D, Helleman M, Westling S. Predictable, Collaborative and Safe: Healthcare Provider Experiences of Introducing Brief Admissions by Self-referral for Self-harming and Suicidal Persons with a History of Extensive Psychiatric Inpatient Care. Issues Ment Health Nurs. 2019 Jul;40(7):548-556. doi: 10.1080/01612840.2019.1585497. Epub 2019 May 17. — View Citation

Lindkvist RM, Westling S, Liljedahl SI, Landgren K. A Brief Breathing Space: Experiences of Brief Admission by Self-Referral for Self-Harming and Suicidal Individuals with a History of Extensive Psychiatric Inpatient Care. Issues Ment Health Nurs. 2021 Feb;42(2):172-182. doi: 10.1080/01612840.2020.1789787. Epub 2020 Aug 7. — View Citation

Lindseth A, Norberg A. A phenomenological hermeneutical method for researching lived experience. Scand J Caring Sci. 2004 Jun;18(2):145-53. doi: 10.1111/j.1471-6712.2004.00258.x. — View Citation

Strand M, von Hausswolff-Juhlin Y. Patient-controlled hospital admission in psychiatry: A systematic review. Nord J Psychiatry. 2015;69(8):574-86. doi: 10.3109/08039488.2015.1025835. Epub 2015 Apr 2. — View Citation

Westling S, Daukantaite D, Liljedahl SI, Oh Y, Westrin A, Flyckt L, Helleman M. Effect of Brief Admission to Hospital by Self-referral for Individuals Who Self-harm and Are at Risk of Suicide: A Randomized Clinical Trial. JAMA Netw Open. 2019 Jun 5;2(6):e195463. doi: 10.1001/jamanetworkopen.2019.5463. Erratum In: JAMA Netw Open. 2019 Oct 2;2(10):e1913724. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Perceived effective components of Brief Admission for adolescents	Qualitative data from interviews	60mins
Primary	Potential adaptations of the method to better fit adolescents	Qualitative data from interviews	60mins
Primary	Areas where Brief Admission have the most prominent perceived effects in adolescents	Qualitative data from interviews	60mins