Twelve months effect of self-referral to inpatient treatment on patient activation,recovery, symptoms and functioning: A randomized controlled study |
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| Affiliation: | 1. Nidaros Community Mental Health Centre, Division of Psychiatry, St. Olav’s University Hospital, Trondheim, Norway;2. Tiller Community Mental Health Centre, Division of Psychiatry, St. Olav’s University Hospital, Trondheim, Norway;3. Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway;4. Department of Research and Development, Division of Psychiatry, St. Olavs University Hospital, Trondheim, Norway;5. Department of Public Health and General Practice, Faculty of Medicine, NTNU, Trondheim, Norway;6. Department of Applied Social Sciences, Faculty of Health and Social Sciences, Norwegian University of Science and Technology, Trondheim, Norway;7. KBT, Department of User Experience and Service Development, Trondheim, Norway;8. NAPHA, Norwegian Resource Centre for Community Mental Health, Trondheim, Norway;9. Department of Brøset, Centre for Research and Education, Division of Psychiatry, St. Olav’s University Hospital, Trondheim, Norway;10. Department of Social Work and Health Science, Faculty of Social Science and Technology Management, NTNU, Trondheim, Norway |
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| Abstract: | ![]()
ObjectiveTo investigate the effect of having a contract for self-referral to inpatient treatment (SRIT) in patients with severe mental disorders.MethodsA 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.ResultsThere 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).ConclusionThere were no group differences after 12 months, but both groups maintained their baseline levels.Practice implicationsSRIT 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. |
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| Keywords: | Patient participation Self-referral to inpatient treatment Patient controlled admission Patient activation Recovery |
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