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The London Survey of Psychiatric Intensive Care Units: psychiatric intensive care; patient characteristics and pathways for admission and discharge

Published online by Cambridge University Press:  15 September 2005

Stephen M Pereira ,
May Sarsam ,
Kamaldeep Bhui  and
Carol Paton
Stephen M Pereira
Affiliation:
Honorary Senior Lecturer in Psychiatry
May Sarsam
Affiliation:
Clinical Psychologist in Training, Division of Clinical Psychology, University of Liverpool, Merseycare NHS Trust
Kamaldeep Bhui
Affiliation:
Professor in Epidemiological Psychiatry, Barts and the London School of Medicine, London
Carol Paton
Affiliation:
Chief Pharmacist, Oxleas NHS Trust, Dartford, Kent, UK

Abstract

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Background: Psychiatric intensive care facilities have previously been poorly defined, with uncertainty existing about the appropriateness of admissions.

Aim: To offer the first large-scale systematic survey describing the clinical characteristics of patients admitted to Psychiatric Intensive Care Units.

Method: A questionnaire was sent to ward managers of every Psychiatric Intensive Care Unit in London for completion on a chosen census day. Individual demographic and clinical patient characteristics were collected, along with admission and discharge pathways.

Results: Of 186 patients on 17 NHS PICUs in London, we obtained data for 172. 80% of patients were male, with a mean age of 33; 50% were Black and all but 2 were involuntarily detained. 66% had a diagnosis of schizophrenia and 55% of admissions were due to physical aggression. 73% of the sample had at least one ‘complex need’, which was most commonly substance misuse. Black patients were younger, more likely to be male and to have a forensic history (54% vs. 31%) than white patients. A slightly lower percentage (70% vs. 79%) of Black patients were described as having complex needs. White patients were more likely to have a personality disorder or a second diagnosis.

Conclusions: Patients admitted to psychiatric intensive care units were most likely to have major psychosis, complex needs and to use illicit substances. Ethnic variations warrant further study.

Declaration of Interest: The project was partly funded by the Department of Health.

Keywords

PICUspatient characteristicscare pathways
Type
Original Paper
Information
Journal of Psychiatric Intensive Care , Volume 1 , Issue 1 , September 2005 , pp. 17 - 24
Copyright
© 2005 NAPICU

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