Borderline personality disorder and the ethics of risk management: The action/consequence model.
Dan Warrender
https://pubmed.ncbi.nlm.nih.gov/28100114Actively Recruiting
Age: 18Years - 65Years
All Genders
ID06406972
Brief Admission by Self-referral for Individuals With Self-harm: Effects on Compulsory Care
Led by Region Skane · Updated on 2025-08-14
7000
Participants Needed
4
Research Sites
N/A
Total Duration
On this page
Sponsors
R
Region Skane
Lead Sponsor
L
Lund University
Collaborating Sponsor
AI-Summary
What this Trial Is About
Researchers are evaluating a treatment model called Brief Admission by self-referral (BA) designed for individuals with traits of borderline personality disorder who self-harm. This model aims to reduce self-harm and compulsory care by promoting patient autonomy and person-centered care. The study compares different clinics implementing BA at various times, focusing on outcomes related to compulsory care, voluntary inpatient care, and mortality. The treatment involves an individualized contract that allows patients to self-refer for inpatient treatment limited to a maximum of three nights, three times per month. The study uses a register-based observational approach, comparing periods before and after BA implementation across multiple clinics including Lund, Linköping, Helsingborg, and Norrköping. The comparison groups consist of time periods before and after BA implementation at these sites. Participants will be monitored through registry data from September 15, 2010, to December 31, 2025. Researchers will measure days with compulsory admission, days with voluntary psychiatric admission, duration of free intervals between admissions, mortality, and numbers of compulsory and voluntary admissions. This long-term observation will help assess the impact of BA on inpatient care and mortality in this population.
CONDITIONS
Brief Title
Brief Admission by Self-referral for Individuals With Self-harm: Effects on Compulsory Care
Who Can Participate
Age: 18Years - 65Years
All Genders
Eligibility Criteria
You may qualify if you...
- Living in the uptake area of Lund, Linköping, Helsingborg or Norrköping
- Age 18 to 65 years at the time of inclusion
- Admitted to hospital diagnosed with borderline personality disorder (ICD-10 F60.3), or admitted at least twice with intentional self-harm (X60-83) combined with one or more of the following: ADHD (F90.0-F90.X), Bipolar disorder type 2 (F31.8W, F318A-F, F31.0, F31.8-9, F31.8W), Autism spectrum disorders (F84.0, F84.1, F84.5), or Mild intellectual disability (F70.0-F70.9)
You will not qualify if you...
- Not fulfilling the above inclusion criteria
AI-Screening
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1
2
3
Your Study Journey
Screening
Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
1 visit (in-person)
Brief Admission by Self-referral
Duration - Up to 5 years
Participants may self-refer for brief inpatient admissions limited to a maximum of three nights, up to three times per month, through an individualised contract.
Admissions as needed, up to 3 times per month
Long-term Monitoring
Duration - Up to 5 years
Participants are observed over time for outcomes related to compulsory and voluntary psychiatric admissions and other health indicators.
Periodic assessments according to routine care
Trial Site Locations
Total: 4 locations
1
Division of Psychiatry, Region Skåne
Lund, Skåne County, Sweden, 22185
Actively Recruiting
2
Region Östergötland
Linköping, Sweden, 581 91
Actively Recruiting
3
Statistiska centralbyrån
Solna, Sweden, 171 54
Actively Recruiting
4
Socialstyrelsen
Stockholm, Sweden, SE-106 30
Actively Recruiting
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Research Team
S
Sofie Sofie, PhD
J
Josefin Vikström Eckevall, PhD
How is the study designed?
Study Type
OBSERVATIONAL
Masking
N/A
Allocation
N/A
Model
N/A
Primary Purpose
N/A
Number of Arms
12
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Published Research Related To This Trial
On the potential for iatrogenic effects of psychiatric crisis services: The example of dialectical behavior therapy for adult women with borderline personality disorder.
Trevor N Coyle, Jennifer A Shaver, Marsha M Linehan
https://pubmed.ncbi.nlm.nih.gov/29369662A standardized crisis management model for self-harming and suicidal individuals with three or more diagnostic criteria of borderline personality disorder: The Brief Admission Skåne randomized controlled trial protocol (BASRCT).
Sophie I Liljedahl, Marjolein Helleman, Daiva Daukantaité...
https://pubmed.ncbi.nlm.nih.gov/28619050Patient-controlled hospital admission in psychiatry: A systematic review.
Mattias Strand, Yvonne von Hausswolff-Juhlin
https://pubmed.ncbi.nlm.nih.gov/25832757Effect of Brief Admission to Hospital by Self-referral for Individuals Who Self-harm and Are at Risk of Suicide: A Randomized Clinical Trial.
Sofie Westling, Daiva Daukantaite, Sophie I Liljedahl...
https://pubmed.ncbi.nlm.nih.gov/31173128Predictable, 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.
Rose-Marie Lindkvist, Kajsa Landgren, Sophie I Liljedahl...
https://pubmed.ncbi.nlm.nih.gov/31099707A randomized controlled trial comparing self-referral to inpatient treatment and treatment as usual in patients with severe mental disorders.
Vidir Sigrunarson, Inger Elise Opheim Moljord, Aslak Steinsbekk...
https://pubmed.ncbi.nlm.nih.gov/27739334Patient-controlled hospital admission for patients with severe mental disorders: a nationwide prospective multicentre study.
C T Thomsen, M E Benros, T Maltesen...
https://pubmed.ncbi.nlm.nih.gov/29504127