Patient-controlled admission to in-patient care based on shared decision making – a method to reduce compulsory psychiatric in-and outpatient care.

There is a wide variation in the use of compulsory care between regions in Sweden. The reason for this has so far not been explained. Contributory factors such as the provision of psychiatric beds only explain the variation to a minor part.

Furthermore, the relative lack of research in this field has to be challenged since it is a serious matter to deprive a patient’s liberty without evidence-based guidelines that guaranties equality in the use of legal rights.

Patient-controlled admission (PCA) to inpatient care is, together with shared decition making (SDM), promising interventions that have preliminarily shown to decrease compulsory care.The purpose of PCA is to increase the patient´s involvement in her own healthcare and improve her ability to manage crises and signs of illness.

The popularly elected Region Stockholm Assembly have decided to implement the method for all patients with a history of in-patient care in Region Stockholm, The present study will follow up effects of this with a main focus on compulsory care.

Patients can contact a inpatient wards and be admitted when there is a need without being questionned based on an agreement established using SDM.

Research in Sweden and abroad have shown a decrease in involuntary admissions and coercive actions using PCA, but the samples have so far been small. The current research project enables to study it´s effects in large samples. Apart from this, self-report measures on quality of life and autonomy will be assessed.