A retrospective medical record review of patients' decisions to utilise or refrain from brief admission.

backgroundBrief Admission (BA) allows patients to independently access short-term psychiatric care during periods of acute stress or perceived threat, offering a safe and structured respite. BA has been associated with reduced self-harm and hospital readmissions. Understanding the factors behind individual differences in BA use and experience is therefore essential.

aimTo examine patients' decisions to utilise or refrain from brief admission.

methodsA retrospective review of 66 medical records (representing 47% of all cases with BA agreements) was conducted using a convergent mixed-methods design. Conventional qualitative content analysis was performed, and the resulting categories were summarized using frequencies and percentages based on the number of records assigned to each category.

resultsAccording to the medical records, 49% of the patients had never utilised BA, while 23% reported using it less than once per year. The patients perceived BA as beneficial in managing their mental health. By maintaining meaningful activities and self-care routines, the patients were able to preserve behaviours that contributed to their well-being during BA. Identified challenges that could hinder the utilisation of BA included difficulties in assessing appropriate timing, staff attitudes, fear of detention, concerns about contact with other individuals with mental health problems, and the need for social support to facilitate engagement with BA. Despite BA's aim of offering a safe environment, it may also trigger past traumatic or negative experiences in patients and relatives, potentially limiting its use.

conclusionsAccess to BA may enhance patient well-being. Given the overlapping challenges patients often face, individually tailored strategies, supported by existing networks and outpatient staff, can help determine when BA or other interventions are appropriate.