title: More than just a bed: mental health service users' experiences of self-referral admission.
abstract: BACKGROUND
  Several community mental health centres and mental hospitals in Norway now allow users with a diagnosis of severe mental illness to self-refer for admission. This give a group of service users who are well-known to service providers the opportunity to refer themselves for short inpatient stays without contacting their doctor, a duty doctor or emergency department. Evidence on self-referral admissions is lacking.
  
  
  OBJECTIVE
  To explore service users' experiences of having the opportunity to refer themselves for a short inpatient stay.
  
  
  METHODS
  Forty-two qualitative semi-structured interviews were undertaken between 2010 and 2014 in a group of 28 service users with serious mental illness and with or without substance abuse problems. All respondents had a contract which allowed them to self-refer for inpatient treatment. Systematic text condensation was applied in the analyses.
  
  
  RESULTS
  Self-referral inpatient admission is more than just a bed. It was perceived as a new, unconventional health service, which differed substantially from earlier experiences of inpatient care and was characterised by different values and treatment principles. The differences were related to the content, quality and organisation of treatment. Having the option to decide about admission for oneself and having access to services focusing on individual needs seem to enhance service users' confidence, both in the services they use and in their own ability to cope with everyday life.
  
  
  CONCLUSIONS
  Self-referral inpatient admission is a concrete example of how a user involvement policy can be implemented in mental health services. It is important to emphasise that the self-referral admission process described here is an offer in development and that we are awaiting findings from a larger RCT study. More evidence is needed to determine what aspects of the service are helpful to service users, the long-term effects, appropriateness and cost-effectiveness, and how the service can be integrated into the mental health system.
authors.affiliation: Norwegian Resource Centre for Community Mental Health, NTNU Social Research AS, Trondheim, Norway.
authors.forename: Turid Møller
authors.initials: TM
authors.lastname: Olsø
authors.affiliation: Forensic Department Brøset, Centre for Research and Education in Forensic Psychiatry, St. Olavs University Hospital, P.O. 1803, Lade, NO-7440, Trondheim, Norway.
authors.forename: Camilla Buch
authors.initials: CB
authors.lastname: Gudde
authors.affiliation: Nidaros Community Mental Health Centre, St. Olav's University Hospital, Trondheim, Norway ; Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: Inger Elise Opheim
authors.initials: IE
authors.lastname: Moljord
authors.affiliation: Norwegian Resource Centre for Community Mental Health, NTNU Social Research AS, Trondheim, Norway.
authors.forename: Gretha Helen
authors.initials: GH
authors.lastname: Evensen
authors.affiliation: Resource Centre for Service User Experience and Service Development (KBT Middle-Norway), Mental Health, NO-7409, Trondheim, Norway.
authors.forename: Dag Øivind
authors.initials: DØ
authors.lastname: Antonsen
authors.affiliation: Nidaros Community Mental Health Centre, St. Olav's University Hospital, Trondheim, Norway ; Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: Lasse
authors.initials: L
authors.lastname: Eriksen
keywords: Mental health services; Mental illness; Self-referral; User experiences; User involvement