Brief Admission by Self-Referral: A 4-Year Follow-Up on Utilisation Patterns and Experiences

Brief Admission by self-referral (BA) is a crisis intervention for individuals with recurrent self-harm and suicidal ideation. While short-term effects are documented, long-term utilisation patterns remain unclear. This study examines BA usage over 4 years, identifies distinct utilisation profiles, and qualitatively explores participants' experiences with BA over time. Participants were 62 individuals from a prior randomised controlled trial who provided informed consent for follow-up. Using a mixed-methods convergent parallel design, quantitative and qualitative data were collected simultaneously, analysed separately, and integrated during the discussion. BA utilisation and profiles were examined quantitatively, while qualitative content analysis was applied to open-ended responses. When analysing mean levels across the entire sample, BA usage initially averaged 8 days per 6-month period but gradually declined over 4 years to 3-4 days. However, cluster analysis revealed distinct BA usage trajectories across three utilisation profiles: Cluster 1 (n = 40) exhibited consistently low BA usage, Cluster 2 (n = 14) showed a gradual decline following an initial phase of engagement, and Cluster 3 (n = 8) maintained high and sustained BA usage throughout the 4-year period, reporting greater impairments but strong satisfaction with BA. These individuals valued BA for its structured support, autonomy, and sense of security. BA appears to serve as both a form of self-care and a gateway to broader psychiatric support, particularly for those with greater functional impairments. To optimise its long-term effectiveness, structural barriers, access inconsistencies, and stigma must be addressed through better integration into psychiatric services.