A 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): Study Protocol

Research output: Contribution to journalArticle

Abstract

Background: Brief Admission is a crisis and risk management strategy in which self-harming and suicidal individuals with three or more diagnostic criteria of borderline personality disorder self-admit to hospital at times of increasing risk when other efforts to stay safe are failing. Standardized in the current randomized controlled trial, the intensity of Brief Admission Skåne is implemented in durations of three days, with a maximum frequency of three times a month. Brief Admission is integrated into existing treatment plans in advance of crises to prevent reliance on general psychiatric admissions for risk management, as these may be lengthy, unstructured, and of uncertain therapeutic value.
Methods/design: The overall objective of the Brief Admission Skåne randomized controlled trial is to determine if Brief Admission can replace general psychiatric admission for self-harming and suicidal individuals with complex mental illness at times of escalating risk. Other objectives of the study are to evaluate whether Brief Admission increases daily functioning and enhances coping, reduces psychiatric symptoms including frequency and severity of self-harm and suicidal behaviours. A final objective is to determine if Brief Admission is an effective crisis management model for this population. Participants are randomized at an individual level to either Brief Admission Skåne plus Treatment as Usual or Treatment As Usual. Based on a priori power analyses, N = 124 participants will be recruited to the study. Data collection is in progress, and will continue until June 2018. All participant data are single-blinded and will be handled with intention-to-treat analysis.
Discussion: Based on the combined clinical experience of our international research group, the Brief AdmissionSkåne randomized controlled trial upon which the current protocol is based represents th e first initiative tostandardize, implement and evaluate Brief Admission amongst self-harming and suicidal individuals, including thosewith borderline traits. Objectively measuring protocol fidelity and developing English-language Brief Admissionstudy protocols and training materials are implementation and dissemination targets developed in order tofacilitate adherent international export of Brief Admission Skåne.Trial registration: NCT02985047. Registered November 25, 2016. Retrospectively registered.

Details

Authors
Organisations
External organisations
  • Radboud University Medical Center
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Psychology

Keywords

  • Brief admission Skåne, Self-harm, Suicide, Borderline Personality Disorder, BASRCT
Original languageEnglish
Number of pages15
JournalBMC Psychiatry
Volume17
Issue number220
StatePublished - 2017 Jun 16
Peer-reviewedYes