Ulf Jonsson

Research problem This project investigates whether the crisis intervention patient-initiated brief admission (PIBA) can prevent involuntary psychiatric care and reduce severe deteriorations (including suicidality) among children and adolescents with complex psychiatric problems. It also examines the organizational, competence-related, and economic prerequisites for a sustainable, equitable implementation, as well as patients’ and relatives’ experiences of PIBA. Specific questions Effects on Healthcare Utilization and Acute Deterioration How does PIBA affect the extent of involuntary measures, inpatient care, emergency visits, and outpatient interventions, and can it prevent severe deterioration (including suicidality)? Organizational and Competence Requirements Which resources and structures are needed for long-term, equitable implementation of PIBA within Child and Adolescent Psychiatry (BUP), and how are workload and collaboration affected? Patient and Family Perspectives How do children and adolescents, as well as their relatives, experience PIBA in terms of well-being and participation, and how can these experiences help reduce inequalities in care? Data and Methods Study 1 (Quasi-experimental Register Study): Analyzes healthcare utilization and involuntary measures before/after PIBA, using national registry data. Study 2 (Mixed Methods): Combines surveys and qualitative methods to explore organizational and health-economic aspects of PIBA. Study 3 (Qualitative Interview Study): Provides in-depth understanding of how children, adolescents, and their relatives experience PIBA. Societal relevance and utilization Evaluating PIBA may help reduce the need for involuntary measures and prolonged hospital stays in BUP, strengthening evidence for early, person-centered interventions. The findings are expected to inform policies, routines, and support materials that foster equitable care and improved collaboration between outpatient and inpatient services. Plan for project realization Conducted over four years in close collaboration with BUP leadership, staff, and patient representatives, the studies will gather national registry data, distribute surveys to relevant staff, and conduct interviews with patients and relatives. Results will be communicated via scientific publications, conferences, and support materials to facilitate the implementation of PIBA.

Research problem and specific questions: There is a critical need to develop easily accessible preventive e-health solutions promoting mental health among young adults, as mental illness and suicide are growing problems in this group (also known as Generation Z). Paradoxically, preventive efforts are sparse, even though 75% of those experiencing long-term mental illness reporting onset before the age of 24. At its heart this project will be co-produced with young adults (18-29 years old), aiming to promote mental health and prevent mental illness, by empowering young adults with mental health literacy (MHL), i.e., the knowledge and skills to manage their own mental health and recognize and respond to stress and mental health concerns within themselves and their peers.Data and method: The situational analysis undertaken in phase 1 will be co-produced with young adults and stakeholders, underpinning the co-designing of a digital e-health solution for MHL including peer support tailored to the needs of young adults. In phase 2, the tailored e-health solution will be assessed for feasibility and pilot tested, using a pre/post-test design and interviews enabling understanding of the intervention’s preliminary efficacy, acceptability (design, content, and usability), demand, practicality, and adaptation.Societal relevance and utilisation: With this project we want to meet young adults on their own arena by co- producing an innovative digital e-health solution to promote mental health and prevent mental illness aligning with the goal of increasing digitalization in Swedish healthcare and social services. Using technology, the program will have the potential to reach many young adults in Sweden and mitigate the onset of mental health problems during the transition to adulthood.Plan for project realization: The Principal investigator (PI) will have the leading role (20% FTE) and will together with a doctoral student (100%) coordinate the operative processes of the project. Phase 1 will be performed months 1-23 and phase 2 and dissemination of results months 24-36. These essential phases will establish the groundwork for a randomized controlled trial (RCT) before the digital solution can be fully implemented.  This line of research will thus contribute to a strong evidence-base, underpinning the future roll out of the digital e-health solution to for example youth centers, municipality young adult social services, and university student health services.

A wide range of mental and behavioral disorders with an early onset can severely impair psychosocial functioning during the transition to adulthood, challenging an individual’s ability to fulfil the demands of adult roles. As a strategy to maximize the outcomes of young adults with conditions such as neurodevelopmental disorders, schizophrenia, and depressive disorders, eligible individuals access social services support in the form of housing assistance (support for daily living provided by the municipality) in accordance with the Social Services Act. In our ongoing research, evaluating a support program for young adults receiving housing assistance, we have observed a need for greater understanding and support for the mental health needs of this vulnerable group. The first phase of the proposed research is a situational analysis, obtaining the views of the young adults themselves and housing assistants. Data underpinning this step will be drawn from national registers and interviews with young adult service users, housing assistance, and representatives from the managerial level. The second phase of this planned project will adapt the Massive Online Open Course (MOOC) “Talk-to-Me”, an evidence-based on-line program designed to improve the mental health and prevent suicide in young adults, to the context of housing assistance. The feasibility will be tested in four large- to mid-sized municipalities. All housing assistants working with the target group will be offered the MOOC, while young service users (aged 18-29 years) will be randomized to immediate or delayed access. Outcomes of interest will include mental health literacy, help-seeking attitudes, and self-efficacy. Participatory research, practitioner research and translation are integral parts of all phases of the project. Our research group includes a PhD student who is working as housing assistant herself. A young adult recipient of housing assistance will also be recruited as a research assistant.