Hostname: page-component-586b7cd67f-r5fsc Total loading time: 0 Render date: 2024-11-24T07:37:27.020Z Has data issue: false hasContentIssue false
  • English
  • Français

Profiling medium secure psychiatric intensive care unit patients

Published online by Cambridge University Press:  10 December 2009

Yasir Kasmi
Yasir Kasmi*
Affiliation:
Specialist Registrar in Forensic Psychiatry
*
Correspondence to: Dr Yasir Kasmi, Newton Lodge, Yorkshire Centre for Forensic Psychiatry, Ouchthorpe Lane, Wakefield, WF1 3SP. E-mail: [email protected]
Get access

Abstract

Little is known about the types of patients admitted to medium secure psychiatric intensive care units, which cater for some of the most mentally disordered and dangerous patients. Only one retrospective study has profiled this subgroup (Dolan & Lawson, 2001).

Using a pre-coded proforma, the study prospectively profiled patient characteristics over a year, for those who were admitted or transferred to the unit. It was predicted that patients detained under Section 3 of the Mental Health Act, 1983 (Civil section) would be overrepresented and present with more management problems.

Information on 24 patients was gathered. Patients detained under Section 3 featured heavily in the cohort and were more difficult to manage, though this did not reach statistical significance. All patients had a criminal history, particularly of violence. Serious adverse incidents on the ward were relatively infrequent. A small number of patients were responsible for the majority of adverse incidents.

The cohort demonstrated serious risk signatures and forensic histories. Management problems may not necessarily reflect underlying mental disorder. There was a trend towards violent offending and co morbid substance misuse. The unit was an effective environment. The study was limited due to low numbers of patients and a lack of comparable populations.

Keywords

Psychiatric intensive care unitmedium secure unitMental Health Act
Type
Original Article
Information
Journal of Psychiatric Intensive Care , Volume 6 , Issue 2 , December 2010 , pp. 65 - 71
Copyright
Copyright © NAPICU 2010

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

Coid, J., Kahtan, N., Gault, S., Cook, A. and Jarman, J. (2001) Medium secure forensic psychiatry services. Comparison of seven English health regions. British Journal of Psychiatry. 178: 55–61.CrossRefGoogle ScholarPubMed
Coid, J., Hickey, N., Kahtan, N., Zhang, T. and Yang, M. (2007) Patients discharged from medium secure forensic psychiatry services: Reconvictions and risk factors. British Journal of Psychiatry. 190: 223–229.CrossRefGoogle ScholarPubMed
Coldwell, J. and Naismith, L. (1989) Violent incidents on special care wards in a Special Hospital. Medicine Science and the Law. 29: 116–123.CrossRefGoogle Scholar
Davies, S., Clarke, M., Hollin, C. and Duggan, C. (2007) Long-term outcomes after discharge from medium secure care: A cause for concern. British Journal of Psychiatry. 191: 70–74.CrossRefGoogle Scholar
Department of Health (2002) National Minimum Standards for General Adult Services in Psychiatric Intensive Care Units (PICU) and Low Secure Environments. Department of Health Publications.Google Scholar
Dolan, M. and Lawson, A. (2001) A psychiatric intensive care unit in a medium-security unit. Journal of Forensic Psychiatry. 12: 684–693.CrossRefGoogle Scholar
Edwards, J., Steed, P. and Murray, K. (2002) Clinical and forensic outcome 2 years and 5 years after admission to a medium secure unit. Journal of Forensic Psychiatry. 13: 68–87.CrossRefGoogle Scholar
Gordon, H. (2001) The provision of intensive care in forensic psychiatry. In: Beer, M., Pereira, S., Paton, C. (eds). Psychiatric Intensive Care. London: Greenwich Medical Media Limited. pp. 252–264.Google Scholar
Gordon, H., Hammond, S. and Veeramani, R. (1998) Special care units in Special Hospitals. Journal of Forensic Psychiatry. 9: 571–587.CrossRefGoogle Scholar
Gudjonsson, G., Rabe-Hesketh, S. and Wilson, B. (2000) Violent incidents on a medium secure unit: The target of assault and the management of incidents. Journal of Forensic Psychiatry. 11: 105–118.CrossRefGoogle Scholar