Clinical trial NCT04962373: Brief Admission for Adolescents Who Self-harm
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
Study type: OBSERVATIONAL
Overall status: RECRUITING
Conditions: Self-Harm, Deliberate
Suicide, Attempted
Suicidal
Non-Suicidal Self Injury
Lead sponsor: Region Skane
Sponsor class: OTHER
Collaborators: name: Lund University
First posted: 2021-07-15
Enrollment: 75
Sex: ALL
Minimum age (years): 13
Maximum age (years): 100
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: CROSS_SECTIONAL
Sampling method: PROBABILITY_SAMPLE
Study population: Adolescents with an active BA contract, their loved ones who have given informed consent to participate and psychiatric staff working with the adolescents.

Brief 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.


Eligibility criteria: 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

Primary outcomes:
measure: Perceived effective components of Brief Admission for adolescents
timeFrame: 60mins
measure: Potential adaptations of the method to better fit adolescents
timeFrame: 60mins
measure: Areas where Brief Admission have the most prominent perceived effects in adolescents
timeFrame: 60mins
Secondary outcomes:
Other outcomes:
Locations:
city: Lund
country: Sweden
facility: Psykiatri och habilitering, Region Skåne
state: Skåne
Study officials:
References:
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.
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.
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.
citation: 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.
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.
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.
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.