Published online by Cambridge University Press: 10 December 2009
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.