From safety to agency: experiences of self-admission among patients with diverse mental health needs

从安全到自主:不同心理健康需求患者的自我入院经历

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Abstract

INTRODUCTION: Self-admission models allow patients to directly contact their psychiatric ward for brief inpatient care based on self-assessed need. To ensure equitable access across all psychiatric services, a broadly applicable, transdiagnostic model for self-admission was developed in Region Stockholm - Sweden's largest public healthcare provider. This study aimed to explore patients' experiences of access to self-admission and its impact on everyday life during mental health problems. METHODS: Sixteen semi-structured interviews were analyzed using thematic analysis. RESULTS: The analysis yielded one overarching theme, From safety to agency, and three themes: Sense of security, Care that supports and Facilitating recovery. The findings illustrate that the self-admission model fostered safety and autonomy and was perceived as facilitating coping strategies, crisis plans, and greater self-awareness and self-management, helping prevent deterioration and reducing emergency care needs. The model also supported maintaining meaningful routines and social connections. Although generally perceived as empowering, some participants struggled with increased autonomy and emphasized the need for greater involvement of relatives. DISCUSSION: The self-admission model appears to effectively promote person-centred care and personal recovery. The study supports previous research as well as demonstrates that a transdiagnostic self-admission model can assist patients with mental health conditions.

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