Hostname: page-component-78c5997874-dh8gc Total loading time: 0 Render date: 2024-11-10T13:08:30.239Z Has data issue: false hasContentIssue false

Characteristics of patients admitted to psychiatric intensive care units

Published online by Cambridge University Press:  13 June 2014

Yasir Kasmi*
Affiliation:
Newton Lodge, Regional Secure Unit, West Yorkshire, UK

Abstract

Objective: A paucity of research exists on the types of patients admitted to psychiatric intensive care units (PICUs), which is important in terms of identifying patient needs, training and service provision. Questions have also been raised as to whether or not ethnic minorities are overrepresented in these units.

Method: A literature review using MeSH headings from a wealth of databases was performed to identify such studies. In addition studies on ethnic minority overrepresentation in psychiatric care were also identified.

Results: Under a dozen studies were identified, mainly from the UK and Australia. Study designs tended to be basic and heterogeneous, but this was reflected in the nature of the study and the data gained. A typical PICU patient emerged, namely a young schizophrenic detained male, belonging to an ethnic minority (if in an inner city), known to mental health services with previous informal, detained and PICU admissions, admitted due to violence and often possessing a forensic history. If a complex need existed, it was usually substance misuse. The inpatient stay tended to be for less than two months and discharge was usually to an acute ward. Ethnic minorities were overrepresented in PICU care.

Conclusions: The literature review highlighted a paucity of good-quality studies in this field. The establishment of a national association of intensive care units as well as national guidelines can only improve services. The reason for ethnic minority over-representation on these units is still far from clear.

Type
Review
Copyright
Copyright © Cambridge University Press 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Dolan, M, Lawson, A. Characteristics and outcomes of patients admitted to a psychiatric intensive care unit in a medium secure unit. Psychiatr Bull 2001; 25: 296299.CrossRefGoogle Scholar
2.Mitchell, G. A survey of psychiatric intensive care units in Scotland. Health Bull 1992; 50: 228232.Google ScholarPubMed
3.Wynaden, D, McGowan, S, Chapman, R, Castle, D, Lau, P, Headford, C. Types of patients in a psychiatric intensive care unit. Aust NZ J Psych 2001; 35: 841845.CrossRefGoogle Scholar
4.Beer, M, Pereira, S, Paton, C. Hot beds of general psychiatry: a national survey of psychiatric intensive care units. Psychiatr Bull 1997; 21:142144.CrossRefGoogle Scholar
5.Dix, R. Psychiatric intensive care and low secure units past, present and future –introducing the Journal of Psychiatric Intensive Care. J Psychiatr Inten Care 2005; 1:12.CrossRefGoogle Scholar
6.Crowhurst, N, Bowers, L. Philosophy, care and treatment on the psychiatric intensive care unit: themes, trends and future practice. J Psychiatr Men Health Nurs 2002; 9: 689695.CrossRefGoogle ScholarPubMed
7.Rachlin, S. On the need for a closed ward in an open hospital: The psychiatric intensive-care unit. Hosp Community Psych 1973; 24: 829835.Google Scholar
8. Glancy Report. Working Party report on security in the NHS psychiatric hospitals. London: HMSO, 1974.Google Scholar
9. Butler Report. Report of the Committee on Mentally Abnormal Offenders, (CMND 6244). London: HMSO, 1975.Google Scholar
10. Reed Report. Report into mentally disordered offenders and others who require similar services (CM 2088). London: HMSO, 1992.Google Scholar
11.Kennedy, H. Therapeutic uses of security: mapping forensic mentai health services by stratifying risk. Adv Psych Treatment 2002; 8: 433443.CrossRefGoogle Scholar
12.Royal College of Psychiatrists. Not just bricks and mortar. Report of Royal College of Psychiatrists working party on the size, staffing, structure, sitting and security of new acute adult in-patient psychiatric units. Council report CK62. London: Royal College of Psychiatrists, 1998.Google Scholar
13.Zigmond, A. Special care wards: are they special? Psychiatr Bull 1995; 19: 310312.CrossRefGoogle Scholar
14.National Institute for Clinical Excellence. The short-term management of disturbed/violent behaviour in in-patient psychiatric settings and emergency departments. Clinical Guideline 25. London: NICE, 2005.Google Scholar
15.Norfolk, , Suffolk, and Cambridgeshire Strategic Health Authority. Independent inquiry into the death of David Bennett. Cambridge: Norfolk, Suffolk and Cambridgeshire Strategic Health Authority, 2003.Google Scholar
16.Department of Health. Delivering race equality in mental health care: An action plan for reform inside and outside services and the Government's response to the independent inquiry into the death of David Bennett. London: Department of Health Publications, 2005.Google Scholar
17.Department of Health National Minimum Standards for General Adult Services in Psychiatric Intensive Care Units (PICU) and Low Secure Environments. London: Department of Health Publications, 2002.Google Scholar
18.Brown, S, Bass, N. The psychiatric intensive care unit (PICU): Patient characteristics, treatment and outcome. J Ment Health 2004; 13: 601609.CrossRefGoogle Scholar
19.Pereira, S, Sarsam, M, Kamaldeep, B, Paton, C. The London survey of psychiatric intensive care units: psychiatric intensive care; patient characteristics and pathways for admission and discharge. J Psychiatr Intens Care 2005; 1:1724.CrossRefGoogle Scholar
20.Smith, A, Humphreys, M. Characteristics of in-patients transferred to a locked ward in a Scottish hospital. Health Bull, 55; 1997: 7782.Google Scholar
21.Goldney, R, Bowes, J, Spence, N, Czechowicz, A, Hurley, R. The psychiatric intensive care unit. Br J Psychiatry 1985; 146: 5054.CrossRefGoogle ScholarPubMed
22.Bowers, L, Crowhurst, N, Alexander, J, Eales, S, Guy, S, McCann, E. Psychiatric nurses' views on criteria for psychiatric intensive care: acute and intensive care staff compared. Int J Nurs Stud 2003; 40: 145152.CrossRefGoogle ScholarPubMed
23.Feinstein, A, Holloway, F. Evaluating the use of a psychiatric intensive care unit: is ethnicity a risk factor for admission. Int J Soc Psychiatry 2002; 48: 3846.CrossRefGoogle ScholarPubMed
24.Thornicroft, G, Davies, S, Leese, M. Health service research and forensic psychiatry: a black and white case. Int Rev Psych 1999; 11: 250257.CrossRefGoogle Scholar
25.Lewis, G, Croft-Jeffreys, C, David, A. Are British psychiatrists racist? Br J Psychiatry 1990; 157: 4CrossRefGoogle ScholarPubMed