Brief admission—a promising novel crisis management method

Abstract

Self-harm among children and adolescents is currently increasing and is strongly associated with suicide. 1 Griffin E McMahon E McNicholas F Corcoran P Perry IJ Arensman E Increasing rates of self-harm among children, adolescents and young adults: a 10-year national registry study 2007–2016. Soc Psychiatry Psychiatr Epidemiol. 2018; 53: 663-671 Crossref PubMed Scopus (81) Google Scholar Inpatient care in child and adolescent psychiatry has not yet evolved sufficiently to provide care that promotes the patient's autonomy and sense of self-determination, 2 Griffiths R Dawber A McDougall T Midgley S Baker J Non-restrictive interventions to reduce self-harm amongst children in mental health inpatient settings: systematic review and narrative synthesis. Int J Ment Health Nurs. 2022; 31: 35-50 Crossref PubMed Scopus (2) Google Scholar but there are various restrictive ways to handle impulsive self-harm and suicidal behaviours. 2 Griffiths R Dawber A McDougall T Midgley S Baker J Non-restrictive interventions to reduce self-harm amongst children in mental health inpatient settings: systematic review and narrative synthesis. Int J Ment Health Nurs. 2022; 31: 35-50 Crossref PubMed Scopus (2) Google Scholar Lengthy inpatient stays, coercive actions, and even forensic hospital admission have been used for life-saving purposes. 2 Griffiths R Dawber A McDougall T Midgley S Baker J Non-restrictive interventions to reduce self-harm amongst children in mental health inpatient settings: systematic review and narrative synthesis. Int J Ment Health Nurs. 2022; 31: 35-50 Crossref PubMed Scopus (2) Google Scholar Given the need for better approaches, it is crucial to study alternative ways to handle crises to prevent iatrogenic damage. 3 Cha CB Franz PJ Guzmán EM Glenn CR Kleiman EM Nock MK Annual research review: suicide among youth—epidemiology, (potential) etiology, and treatment. J Child Psychol Psychiatry. 2018; 59: 460-482 Crossref PubMed Scopus (258) Google Scholar Furthermore, coordinated treatment plans to prevent new crises by bridging the gap between inpatient and outpatient care are often obstructed by the different cultures of these care settings. To date, there are no standardised methods in child and adolescent inpatient care that ease or prevent self-harm without using coercive methods. New non-restrictive methods that reduce the need for lengthy constraining inpatient stays and promote continuity across inpatient and outpatient care are urgently required. 2 Griffiths R Dawber A McDougall T Midgley S Baker J Non-restrictive interventions to reduce self-harm amongst children in mental health inpatient settings: systematic review and narrative synthesis. Int J Ment Health Nurs. 2022; 31: 35-50 Crossref PubMed Scopus (2) Google Scholar Introducing brief admissions by self-referral in child and adolescent psychiatry: an observational cohort study in SwedenOur findings suggest that brief admissions can be successfully implemented in paediatric psychiatry and appear to be an effective crisis management method for adolescents, associated with reduced demand for emergency care. Future randomised controlled trials are warranted. Full-Text PDF