Clinical Trials Logo

Clinical Trial Details — Status: Recruiting

Administrative data

NCT number NCT06406972
Other study ID # 2022-02307-01
Secondary ID
Status Recruiting
Phase
First received
Last updated
Start date September 15, 2010
Est. completion date September 14, 2025

Study information

Verified date April 2024
Source Region Skane
Contact Sofie Sofie, PhD
Phone +46735626099
Email sofie.westling@med.lu.se
Is FDA regulated No
Health authority
Study type Observational [Patient Registry]

Clinical Trial Summary

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.


Recruitment information / eligibility

Status Recruiting
Enrollment 7000
Est. completion date September 14, 2025
Est. primary completion date September 14, 2025
Accepts healthy volunteers No
Gender All
Age group 18 Years to 65 Years
Eligibility 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

Study Design


Intervention

Other:
Brief Admission by self-referral (BA)
Through means of an individualised contract access to self-referral to inpatient treatment limited to a maximum of three nights, three times per month.

Locations

Country Name City State
Sweden Region Östergötland Linköping
Sweden Division of Psychiatry, Region Skåne Lund Skåne
Sweden Statistiska centralbyrån Solna
Sweden Socialstyrelsen Stockholm

Sponsors (3)

Lead Sponsor Collaborator
Region Skane Linkoeping University, Lund University

Country where clinical trial is conducted

Sweden, 

References & Publications (8)

Coyle TN, Shaver JA, Linehan MM. On the potential for iatrogenic effects of psychiatric crisis services: The example of dialectical behavior therapy for adult women with borderline personality disorder. J Consult Clin Psychol. 2018 Feb;86(2):116-124. doi: 10.1037/ccp0000275. — View Citation

Liljedahl SI, Helleman M, Daukantaite D, Westrin A, Westling S. A standardized crisis management model for self-harming and suicidal individuals with three or more diagnostic criteria of borderline personality disorder: The Brief Admission Skane randomized controlled trial protocol (BASRCT). BMC Psychiatry. 2017 Jun 15;17(1):220. doi: 10.1186/s12888-017-1371-6. — 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

Sigrunarson V, Moljord IE, Steinsbekk A, Eriksen L, Morken G. A randomized controlled trial comparing self-referral to inpatient treatment and treatment as usual in patients with severe mental disorders. Nord J Psychiatry. 2017 Feb;71(2):120-125. doi: 10.1080/08039488.2016.1240231. Epub 2016 Oct 14. — 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

Thomsen CT, Benros ME, Maltesen T, Hastrup LH, Andersen PK, Giacco D, Nordentoft M. Patient-controlled hospital admission for patients with severe mental disorders: a nationwide prospective multicentre study. Acta Psychiatr Scand. 2018 Apr;137(4):355-363. doi: 10.1111/acps.12868. Epub 2018 Mar 4. — View Citation

Warrender D. Borderline personality disorder and the ethics of risk management: The action/consequence model. Nurs Ethics. 2018 Nov;25(7):918-927. doi: 10.1177/0969733016679467. Epub 2017 Jan 19. — 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
Other Gender distribution Differences in distribution of diagnoses between men and women 2010-09-15 - 2025-09-14
Other Number of admissions with Brief admission by self-referral (BA) Number of BA admissions (admissions/year) 2010-09-15 - 2025-09-14
Other Compulsory admission - median length Compulsory admission - median length (days/admission) 2010-09-15 - 2025-09-14
Other Voluntary psychiatric admissions - median length Voluntary psychiatric admissions - median length (days/admission) 2010-09-15 - 2025-09-14
Other Number of voluntary psychiatric admissions Number of voluntary psychiatric admissions (admissions/year) 2010-09-15 - 2025-09-14
Primary Days with compulsory admission Days with compulsory admission (days/year) 2010-09-15 - 2025-09-14
Secondary Days with voluntary psychiatric admission Days with voluntary psychiatric admission (days/year) 2010-09-15 - 2025-09-14
Secondary Duration of free intervals between admissions Duration of free intervals between admissions (days) 2010-09-15 - 2025-09-14
Secondary Mortality All cause mortality as well as death by suicide specifically (X60-X84 and Y10-Y34 in ICD10) 2010-09-15 - 2025-09-14
Secondary Number of compulsory admissions Number of compulsory admissions (admissions/year) 2010-09-15 - 2025-09-14
Secondary Number of voluntary psychiatric admissions (admissions/year) Number of voluntary psychiatric admissions 2010-09-15 - 2025-09-14
Secondary Number of compulsory acts/year Number of compulsory acts/year 2010-09-15 - 2025-09-14
See also
  Status Clinical Trial Phase
Completed NCT04127292 - Impact of Clinician Virtual Human Interaction Training in Emotional Self-Awareness on Patients Suicidal Ideation and Suicide Crisis Syndrome N/A
Recruiting NCT06079853 - Nurse Suicide: Physiologic Sleep Health Promotion Trial N/A
Recruiting NCT05423483 - Developing an Intervention to Promote Lethal Means Safety in Suicidal Adolescents Phase 2
Completed NCT03272048 - Identifying Effective Approaches to Counseling on Firearm Safety N/A
Completed NCT05514587 - Meaning of Life Questionnaire (MLQ) in Patients Admitted to the Crisis Centre (MSVCAC)
Enrolling by invitation NCT05639426 - Preventing Youth Violence Through Building Equitable Communities N/A
Completed NCT03703128 - Suicide in People Aged 45-60: A Case-control Psychological Autopsy Study
Completed NCT03646903 - Reducing Help-Seeking Stigma in Young Adults at Elevated Suicide Risk N/A
Not yet recruiting NCT06349915 - A Pilot Evaluation of a Digital Peer Support Intervention for Suicidal Adolescents N/A
Not yet recruiting NCT05558332 - Youth Nominated Support Team N/A
Completed NCT02718248 - Ottawa Suicide Prevention in Men Pilot Study N/A
Completed NCT02094898 - Ketamine for Depression and Suicide Risk Phase 2
Completed NCT01594138 - Linguistic Characteristics of Suicidal Patients in the Emergency Department N/A
Completed NCT01360736 - A Brief Intervention to Reduce Suicide Risk in Military Service Members and Veterans - Study 2 (SAFEMIL) N/A
Completed NCT02228044 - Alcohol, Suicide and HIV Prevention for Teens in Mental Health Treatment N/A
Completed NCT00604097 - Preventing Youth Suicide in Primary Care: A Family Model Phase 3
Completed NCT00387855 - An Evaluation of the SOS (Suicide Prevention) Program N/A
Recruiting NCT03519802 - Evaluation of Cognitive Function in a Suicidal Crisis
Completed NCT05580757 - Pharmacists as Gate Keepers in Suicide Prevention: Needs of Pharmacists
Recruiting NCT03030924 - Wearable Suicidal Early Warning System for Adolescents