‘A Safe Place Where I Am Welcome to Unwind When I Choose to’—Experiences of Brief Admission by Self-Referral for Adolescents Who Self-Harm at Risk for Suicide: A Qualitative Study

Rose-Marie Lindkvist, Sofie Westling, Sophia Eberhard, Björn Axel Johansson, Olof Rask and Kajsa Landgren
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Rose-Marie Lindkvist: Department of Clinical Sciences Lund, Psychiatry, Lund University, 22100 Lund, Sweden
Sofie Westling: Department of Clinical Sciences Lund, Psychiatry, Lund University, 22100 Lund, Sweden
Sophia Eberhard: Department of Clinical Sciences Lund, Psychiatry, Lund University, 22100 Lund, Sweden
Björn Axel Johansson: Department of Clinical Sciences Lund, Psychiatry, Lund University, 22100 Lund, Sweden
Olof Rask: Department of Clinical Sciences Lund, Psychiatry, Lund University, 22100 Lund, Sweden
Kajsa Landgren: Office for Psychiatry and Habilitation, Psychiatry Research Skåne, Region Skåne, 22185 Lund, Sweden

IJERPH, 2021, vol. 19, issue 1, 1-15

Abstract: Evidence is lacking on how to manage imminent suicidality in adolescents with self-harm. Brief Admission by Self-referral (BA) is a crisis-management intervention, developed for adults with self-harm at risk for suicide. Structured, individualized and based on responsible autonomy, BA aims to provide a respite while minimizing negative effects of hospitalization. This qualitative interview study illuminates adolescents’ experiences of BA, adapted for this target group. Nineteen adolescents aged 14 to 19 years, described BA as helpful for timely rest and recovery to save themselves from impulses to self-harm. The individual contract, which is a prerequisite for access to BA, was perceived to give access to professional support in a safe environment, also among adolescents not using their contract. Being trusted with responsibility to self-admit was also hard work with struggles of self-doubt. Challenges included experiencing distrust from staff and fear of not being able to abstain from self-harm, which BA is conditioned upon. However, this condition was also perceived to induce self-motivation and growth. BA appeared well-adapted to the target group, fulfilling needs of predictability, autonomy, and opportunity for recovery to prevent self-harm. Suggestions for improvement included continually informing staff about important features of BA. To further evaluate benefits and challenges of BA, future research may evaluate clinical and health-economic outcomes and perspectives from parents and caregivers.

Keywords: self-referral; self-admission; brief admission; self-harm; child & adolescent psychiatry; adolescents (young adults) (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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