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

Thematic analysis of patient interviews yielded one overarching theme ('From safety to agency') and three subthemes describing experiences of the self-admission model.

• Sixteen semi-structured interviews were conducted and analyzed using thematic analysis.
• The three themes identified were: Sense of security, Care that supports, and Facilitating recovery.
• The study used a broadly applicable, transdiagnostic model for self-admission developed in Region Stockholm, Sweden's largest public healthcare provider.
• The model allowed patients to directly contact their psychiatric ward for brief inpatient care based on self-assessed need.

The self-admission model was perceived by patients as fostering a sense of safety and security in their daily lives.

• The 'Sense of security' theme emerged as one of three primary themes from the analysis.
• Participants reported that the availability of self-admission helped prevent deterioration of their mental health condition.
• The model was perceived as reducing the need for emergency care.
• Knowing that self-admission was accessible appeared to provide a psychological safety net for participants.

The self-admission model was perceived as supporting patients in developing and using coping strategies, crisis plans, and greater self-awareness.

• The 'Care that supports' theme captured how the model facilitated coping strategies and crisis planning.
• Participants reported greater self-awareness and self-management as outcomes associated with access to self-admission.
• The model supported maintaining meaningful routines and social connections.
• Findings indicated that the model helped patients with diverse (transdiagnostic) mental health conditions.

The self-admission model was perceived as facilitating recovery and promoting autonomy, though some patients struggled with the increased autonomy it entailed.

• The 'Facilitating recovery' theme captured perceived benefits for personal recovery.
• The model was generally perceived as empowering by participants.
• Some participants reported struggling with the increased autonomy inherent in the self-admission model.
• Some participants emphasized the need for greater involvement of relatives in the self-admission process.

The transdiagnostic self-admission model was developed to ensure equitable access across all psychiatric services in Region Stockholm.

• Existing self-admission models were not broadly applicable across all psychiatric diagnoses, prompting development of a transdiagnostic version.
• The model was implemented in Region Stockholm, described as Sweden's largest public healthcare provider.
• The study aimed to explore patients' experiences of access to self-admission and its impact on everyday life during mental health problems.
• Sixteen patients with diverse mental health needs were interviewed, reflecting the transdiagnostic intent of the model.

The study's findings support previous research and extend it by demonstrating that a transdiagnostic self-admission model can assist patients with a range of mental health conditions.

• The authors state the study 'supports previous research as well as demonstrates that a transdiagnostic self-admission model can assist patients with mental health conditions.'
• The model appeared to effectively promote person-centred care and personal recovery.
• Prior self-admission research had largely focused on specific diagnoses; this study addresses a gap by examining a transdiagnostic approach.
• The study was qualitative in design, based on 16 semi-structured interviews.