National Survey of Psychiatric Intensive Care, Low Secure and Locked Rehabilitation Services: NHS patient characteristics

Abstract

Aims: To update the benchmark from the 2006 National Survey, comparing users of NHS psychiatric intensive care (PICU) and low secure (LSU) services, and to define 'locked rehabilitation' (LRU) patient characteristics.<br/> Method: A cross-sectional census day questionnaire (November 2016) with a six month follow-up ending in May 2017.<br/>Results: 104 NHS units responded: 73 PICU, 644 patients; 17 LSU, 190 patients; 14 LRU, 183 patients. The typical PICU patient is younger, employed, stays for shorter periods, is more likely to suffer delayed discharge and mood disorder, have complex needs, have had mental health admissions in the last 12 months, be on 1:1 or higher observations, and have fewer antipsychotic and physical health medications but more benzodiazepines. The typical LSU patient is an out of area transfer, least likely to have been admitted for self-harm or non-concordance, and is of Black Other ethnic origin. The typical LRU patient is less likely to be married or have a long-term partner, has the lowest complex needs, but is most likely to have had physical examination and investigations.<br/>Discussion: There has been a rise in PICU and LSU patients from the Black and Minority Ethnic (BAME) population. Length of stay (LoS) for PICU and LSU patients has doubled; there are lower rates of delayed transfers of care.<br/>Conclusions : Our findings demonstrate that PICU and LSU services are providing care to the right patients as they were conceptualised in national guidance, and provide a benchmark for LRU patients.