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Brief user-controlled admission (BUCA) in psychiatric care
Sofie Westling1,2, Josefin Vikström Eckevall1,3, Rose-Marie Lindkvist1
1Psychiatry, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden.
Summary
Brief User-Controlled Admission (BUCA) empowers individuals with severe mental distress to self-manage crisis care through pre-negotiated agreements. This user-led approach enhances satisfaction and daily functioning, aligning with mental health reform priorities.
Area of Science:
- Mental Health Services Research
- Psychiatric Crisis Intervention
- Healthcare Policy
Background:
- Traditional physician gatekeeping in mental health crisis care can be restrictive.
- Severe mental distress necessitates innovative, patient-centered interventions.
- User-led models align with current mental health reform emphasizing autonomy.
Purpose of the Study:
- To evaluate the Brief User-Controlled Admission (BUCA) model for crisis intervention.
- To explore user, staff, and family experiences with BUCA.
- To assess the impact of BUCA on functioning and healthcare utilization.
Main Methods:
- BUCA involves pre-negotiated agreements allowing users to self-initiate short-term inpatient care.
- Studies included adults and adolescents experiencing severe mental distress.
- Outcomes assessed included user satisfaction, functioning, and healthcare costs.
Main Results:
- Users reported high satisfaction, psychological safety, and dignity.
- Staff experienced strengthened therapeutic alliances and collaborative roles.
- BUCA was associated with increased daily functioning and potentially lower healthcare costs for high utilizers.
- Controlled studies did not demonstrate significant reductions in inpatient care duration.
Conclusions:
- BUCA represents a significant shift towards user-led mental healthcare.
- The model enhances user experience and daily functioning.
- BUCA offers a scalable, potentially cost-effective crisis intervention strategy.
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