title: How do patients with severe mental diagnosis cope in everyday life - a qualitative study comparing patients' experiences of self-referral inpatient treatment with treatment as usual?
abstract: BACKGROUND
  Several hospitals in Norway provide short self-referral inpatient treatment to patients with severe mental diagnosis. No studies have compared the experiences of patients who have had the opportunity to self-refer to inpatient treatment with patients who have received treatment as usual. This qualitative study was nested within a randomised controlled trial investigating the effect of self-referral to inpatient treatment. The aim was to explore how patients with severe mental diagnosis coped four months after signing a contract for self-referral, as compared to patients receiving treatment as usual.
  
  
  METHODS
  Data was collected using qualitative individual interviews with patients with severe mental diagnosis, conducted four months after being randomised either to a contract for self-referral (intervention group) or to treatment as usual (control group).
  
  
  RESULTS
  Twenty-five patients participated in interviews - 11 from the intervention group and 14 from the control group. Results four months after randomisation showed that patients with a contract for self-referral appeared to have more confidence in strategies to cope with mental illness and to apply more active cognitive strategies. Patients with a contract also expressed less resignation, hopelessness and powerlessness than patients without a contract. In addition, patients with a contract seemed to be closer to the ideal of living a "normal" life and being a "normal" person.
  
  
  CONCLUSIONS
  The results indicate that the patients who had a contract for self-referral had come further in the recovery process and should possibly be better off during treatment.
authors.affiliation: Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway. marit.b.rise@ntnu.no.
authors.forename: Marit B
authors.initials: MB
authors.lastname: Rise
authors.forename: Gretha H
authors.initials: GH
authors.lastname: Evensen
authors.forename: Inger Elise O
authors.initials: IE
authors.lastname: Moljord
authors.forename: Marit
authors.initials: M
authors.lastname: Rø
authors.forename: Dagfinn
authors.initials: D
authors.lastname: Bjørgen
authors.forename: Lasse
authors.initials: L
authors.lastname: Eriksen
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology* / Q000628:therapy*; D008875:Middle Aged; D009664:Norway; D036301:Qualitative Research; D012017:Referral and Consultation