I E O Moljord1, M L Lara-Cabrera2, Ø Salvesen3, M B Rise4, D Bjørgen5, D Ø Antonsen5, T M Olsø6, G H Evensen6, C B Gudde7, O M Linaker8, A Steinsbekk3, L Eriksen9. 1. Nidaros Community Mental Health Centre, Division of Psychiatry, St. Olav's University Hospital, Trondheim, Norway; Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of Research and Development, Division of Psychiatry, St. Olavs University Hospital, Trondheim, Norway. Electronic address: inger.elise.opheim.moljord@stolav.no. 2. Tiller Community Mental Health Centre, Division of Psychiatry, St. Olav's University Hospital, Trondheim, Norway; Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of Research and Development, Division of Psychiatry, St. Olavs University Hospital, Trondheim, Norway. 3. Department of Public Health and General Practice, Faculty of Medicine, NTNU, Trondheim, Norway. 4. Department of Applied Social Sciences, Faculty of Health and Social Sciences, Norwegian University of Science and Technology, Trondheim, Norway. 5. KBT, Department of User Experience and Service Development, Trondheim, Norway. 6. NAPHA, Norwegian Resource Centre for Community Mental Health, Trondheim, Norway. 7. Department of Brøset, Centre for Research and Education, Division of Psychiatry, St. Olav's University Hospital, Trondheim, Norway; Department of Social Work and Health Science, Faculty of Social Science and Technology Management, NTNU, Trondheim, Norway. 8. Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of Research and Development, Division of Psychiatry, St. Olavs University Hospital, Trondheim, Norway. 9. Nidaros Community Mental Health Centre, Division of Psychiatry, St. Olav's University Hospital, Trondheim, Norway; Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
Abstract
OBJECTIVE: To investigate the effect of having a contract for self-referral to inpatient treatment (SRIT) in patients with severe mental disorders. METHODS: A randomized controlled trial with 53 adult patients; 26 participants received aSRIT contract, which they could use to refer themselves into a Community Mental Health Centre up to five days for each referral without contacting a doctor in advance. Outcomes were assessed after 12 months with the self-report questionnaires Patient Activation Measure (PAM-13), Recovery Assessment Scale (RAS), and the Behavior and Symptom Identification Scale (BASIS-32) and analyzed using linear mixed and regression models. RESULTS: There was no significant effect on PAM-13 (estimated mean difference (emd) -0.41, 95% CI (CI):-7.49-6.67), nor on the RAS (emd 0.02, CI:-0.27-0.31) or BASIS-32 (0.09, CI:-0.28-0.45). An exploratory post hoc analysis showed effect of SRIT in those with low PAM below ≤47 (p=0.049). CONCLUSION: There were no group differences after 12 months, but both groups maintained their baseline levels. PRACTICE IMPLICATIONS: SRIT contracts can be recommended as it supports the rights to self-determination, promote user participation in decision-making in own treatment without any indication of adverse effects.
RCT Entities:
OBJECTIVE: To investigate the effect of having a contract for self-referral to inpatient treatment (SRIT) in patients with severe mental disorders. METHODS: A randomized controlled trial with 53 adult patients; 26 participants received a SRIT contract, which they could use to refer themselves into a Community Mental Health Centre up to five days for each referral without contacting a doctor in advance. Outcomes were assessed after 12 months with the self-report questionnaires Patient Activation Measure (PAM-13), Recovery Assessment Scale (RAS), and the Behavior and Symptom Identification Scale (BASIS-32) and analyzed using linear mixed and regression models. RESULTS: There was no significant effect on PAM-13 (estimated mean difference (emd) -0.41, 95% CI (CI):-7.49-6.67), nor on the RAS (emd 0.02, CI:-0.27-0.31) or BASIS-32 (0.09, CI:-0.28-0.45). An exploratory post hoc analysis showed effect of SRIT in those with low PAM below ≤47 (p=0.049). CONCLUSION: There were no group differences after 12 months, but both groups maintained their baseline levels. PRACTICE IMPLICATIONS: SRIT contracts can be recommended as it supports the rights to self-determination, promote user participation in decision-making in own treatment without any indication of adverse effects.
Authors: M Ådnanes; L Melby; J Cresswell-Smith; H Westerlund; L Rabbi; M Z Dernovšek; L Šprah; R Sfetcu; C Straßmayr; V Donisi Journal: BMC Health Serv Res Date: 2018-07-03 Impact factor: 2.655
Authors: Maria Smitmanis Lyle; Emelie Allenius; Sigrid Salomonsson; Anna Björkdahl; Mattias Strand; Lena Flyckt; Clara Hellner; Tobias Lundgren; Nitya Jayaram-Lindström; Alexander Rozental Journal: BMJ Open Date: 2022-08-16 Impact factor: 3.006