The psychiatric intensive care unit: A prospective survey of patient demographics and outcomes at seven English PICUs

Abstract

Background: Psychiatric intensive care units (PICUs) have become a standard part of UK mental health services. They treat patients who may be very unwell and who are usually compulsorily detained. There is little published data about the clinical activity of such units to provide an evidence base for clinical governance.Aim: To describe the socio-demographic characteristics, mental state and outcome of treatment for 332 patients admitted consecutively to seven English PICUs.Method: Prospective, multi-centre case note analysis.Results: PICU patients were predominantly Caucasian males, in their mid thirties, with complex needs and chronic psychotic illness often complicated by substance misuse. Most were admitted because of perceived risk of violence to others. Whilst most admissions appeared to be broadly in line with Department of Health guidelines some patients experienced an excessive length of PICU stay. Patients from particular BME groups were over-represented.Conclusions: PICUs appear to deliver effective treatment but are not always the least restrictive environment as envisaged by the Department of Health. Further work is needed to evaluate treatment interventions and develop valid measures of quality of care.