This commentary aims to explore the benefits of having a designated, specialised clinical lead on the psychiatric intensive care unit (PICU). It discusses the problems, disadvantages and risks of not having such leadership, especially where a multiple consultant psychiatrist model is employed. The impact of clinical leadership on specific aspects of work on the PICU is examined including multidisciplinary team working, patients’ clinical time and safety, decision making, resource expertise, delayed discharges, and staff stress levels. Reference is made to standards in the literature which show that departure from designated leadership on the PICU is unsatisfactory.
