Psychiatric intensive-care unit

A Psychiatric Intensive Care Unit (PICU) is a type of psychiatric in-patient ward. On these wards staffing levels are higher than on a normal acute admission ward.

This article is about Psychiatric Intensive Care Units. For the intensive care unit for children, which shares the acronym PICU, see Pediatric intensive care unit.

PICUs are designed to look after patients who cannot be managed on open (unlocked) psychiatric wards due to the level of risk the patient poses to themselves or others.[1] The patient's length of stay is normally short (a few weeks) rather than prolonged as the patient should be treated and returned to an open ward as soon as their mental state is stable.[1] Many PICUs have a seclusion room.

There is a common misconception amongst the public and some patients that a PICU is a type of "punishment ward" or "segregation unit" (as found in UK prisons). The role of a PICU does not encompass either of these two functions and patients are not sent to a PICU as a punishment for their behaviour. Clinical assessment of the risks posed by the patient to themselves and to others should be included in any decision to transfer a patient to a PICU.

Environment

PICUs typically have the following environmental components:

  • Higher than normal staff to patient ratios;
  • All exit/entry doors are locked;
  • Windows have restricted opening widths;
  • Visitors have their bags searched on entry, and dangerous items are removed;
  • Access to areas such as the unit's kitchen and secure external area (such as a garden) are controlled and risk assessed for each patient.

National Association of Psychiatric Intensive Care Units

The UK-based National Association of Psychiatric Intensive Care Units and low secure units (NAPICU) is a multi professional organisation which aims to improve the practice within PICUs and low secure services, undertake research and audit and provide training and education. NAPICU has helped develop national guidance and worked with partner organisations to help develop standards for units to become accredited.

Journal of Psychiatric Intensive Care

The Association publishes the Journal of Psychiatric Intensive Care.

References
  1. "Child and Adolescent Mental Health Services (CAMHS) – Psychiatric intensive care unit" (PDF). NHS. NHS England. 3 April 2018. Retrieved 9 December 2020.
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