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Brief user-controlled admission (BUCA) in psychiatric care.

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Title: Brief user-controlled admission (BUCA) in psychiatric care.
Authors: Westling, Sofie (AUTHOR), Vikström Eckevall, Josefin (AUTHOR), Lindkvist, Rose-Marie (AUTHOR)
Source: Australasian Psychiatry. Apr2026, Vol. 34 Issue 2, p142-146. 5p.
Subjects: Inpatient care, Patient autonomy, Therapeutic alliance, Psychiatric hospital care, Crisis intervention (Mental health services), Hospital admission & discharge
Abstract: Brief User-Controlled Admission (BUCA) refers to a set of crisis interventions in which the traditional gatekeeping role of the physician is bypassed, allowing service users to independently decide when to access short-term inpatient care through a pre-negotiated agreement. Examples include Brief Admission by self-referral, Patient-Initiated Brief Admission, Patient-Controlled Admission, and Self-Referral to Inpatient Treatment. The structured agreement promotes predictability and collaboration, enabling the user to assume control over their care. BUCA has been studied in adults and adolescents with severe mental distress at risk for escalation of symptoms, self-harm or suicide. Users report high satisfaction, describing the agreement as a source of psychological safety, dignity, and proactive crisis management. Staff experience strengthened therapeutic alliances and role shifts from gatekeeping to collaboration. Families experience relief, though they may need information and support adapting to the user-led structure. BUCA has been associated with increased functioning in daily life, and lower healthcare costs, particularly among users with high service utilization. While earlier studies have suggested potential reductions in inpatient care, studies including controls have not proven significant effects. Representing a shift towards user-led care, BUCA offers a scalable and potentially cost-effective model aligned with current mental health reform priorities. [ABSTRACT FROM AUTHOR]
Copyright of Australasian Psychiatry is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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Items – Name: Title
  Label: Title
  Group: Ti
  Data: Brief user-controlled admission (BUCA) in psychiatric care.
– Name: Author
  Label: Authors
  Group: Au
  Data: <searchLink fieldCode="AR" term="%22Westling%2C+Sofie%22">Westling, Sofie</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Vikström+Eckevall%2C+Josefin%22">Vikström Eckevall, Josefin</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Lindkvist%2C+Rose-Marie%22">Lindkvist, Rose-Marie</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22Australasian+Psychiatry%22">Australasian Psychiatry</searchLink>. Apr2026, Vol. 34 Issue 2, p142-146. 5p.
– Name: Subject
  Label: Subjects
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Inpatient+care%22">Inpatient care</searchLink><br /><searchLink fieldCode="DE" term="%22Patient+autonomy%22">Patient autonomy</searchLink><br /><searchLink fieldCode="DE" term="%22Therapeutic+alliance%22">Therapeutic alliance</searchLink><br /><searchLink fieldCode="DE" term="%22Psychiatric+hospital+care%22">Psychiatric hospital care</searchLink><br /><searchLink fieldCode="DE" term="%22Crisis+intervention+%28Mental+health+services%29%22">Crisis intervention (Mental health services)</searchLink><br /><searchLink fieldCode="DE" term="%22Hospital+admission+%26+discharge%22">Hospital admission & discharge</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Brief User-Controlled Admission (BUCA) refers to a set of crisis interventions in which the traditional gatekeeping role of the physician is bypassed, allowing service users to independently decide when to access short-term inpatient care through a pre-negotiated agreement. Examples include Brief Admission by self-referral, Patient-Initiated Brief Admission, Patient-Controlled Admission, and Self-Referral to Inpatient Treatment. The structured agreement promotes predictability and collaboration, enabling the user to assume control over their care. BUCA has been studied in adults and adolescents with severe mental distress at risk for escalation of symptoms, self-harm or suicide. Users report high satisfaction, describing the agreement as a source of psychological safety, dignity, and proactive crisis management. Staff experience strengthened therapeutic alliances and role shifts from gatekeeping to collaboration. Families experience relief, though they may need information and support adapting to the user-led structure. BUCA has been associated with increased functioning in daily life, and lower healthcare costs, particularly among users with high service utilization. While earlier studies have suggested potential reductions in inpatient care, studies including controls have not proven significant effects. Representing a shift towards user-led care, BUCA offers a scalable and potentially cost-effective model aligned with current mental health reform priorities. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of Australasian Psychiatry is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=192851260
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      – Type: doi
        Value: 10.1177/10398562251406034
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      – Code: eng
        Text: English
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      – SubjectFull: Inpatient care
        Type: general
      – SubjectFull: Patient autonomy
        Type: general
      – SubjectFull: Therapeutic alliance
        Type: general
      – SubjectFull: Psychiatric hospital care
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      – SubjectFull: Crisis intervention (Mental health services)
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      – SubjectFull: Hospital admission & discharge
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      – TitleFull: Brief user-controlled admission (BUCA) in psychiatric care.
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            NameFull: Westling, Sofie
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            NameFull: Vikström Eckevall, Josefin
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            NameFull: Lindkvist, Rose-Marie
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            – D: 01
              M: 04
              Text: Apr2026
              Type: published
              Y: 2026
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              Value: 34
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            – TitleFull: Australasian Psychiatry
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