Psychiatric Intensive Care Unit (PICU)

The Psychiatric Intensive Care Unit (PICU) at Southern Hill Hospital is a specialised unit designed to provide intensive care and treatment to male service users experiencing acute psychiatric episodes. Our goal is to offer a safe, secure, and therapeutic environment for men who are in need of intensive mental health support. The PICU caters to individuals who require close monitoring and intervention due to the severity of their mental health condition.

What is a PICU?

A Psychiatric Intensive Care Unit (PICU) is a specialised ward within a mental health hospital. It is designed to provide a higher level of care for service users experiencing severe psychiatric crises. Patients admitted to the PICU often exhibit behaviours that pose a significant risk to themselves or others. These behaviours can include severe agitation, aggression, self-harm, or a heightened risk of suicide.

PICUs are equipped with enhanced security measures, including secure doors and windows, to ensure the safety of both patients and staff. The environment is designed to minimise risks and provide a calming and therapeutic atmosphere. The primary objective of the PICU is to stabilise patients, reduce their symptoms, and facilitate their transition to a less intensive level of care.

Admission Criteria

Admission to the PICU at Southern Hill Hospital is based on a comprehensive assessment conducted by a multidisciplinary team of mental health professionals. The following criteria are considered when determining the need for PICU admission:

Severity of Symptoms: Patients exhibiting severe psychiatric symptoms that cannot be managed in a less intensive setting.
Risk of Harm: Patients who pose a significant risk to themselves or others, including those with a history of violent or self-destructive behaviours.
Failure of Lower Level Care: Patients whose symptoms have not improved despite treatment in a general psychiatric ward or other mental health settings.
Complexity of Condition: Patients with complex psychiatric conditions that require specialised interventions and close monitoring.

Admissions Process

The admissions process to the Psychiatric Intensive Care Unit (PICU) at Southern Hill Hospital begins with a thorough initial assessment. This is conducted by a multidisciplinary team comprising psychiatrists, mental health nurses, and social workers. The assessment aims to understand the severity of the patient's condition, the risks involved, and the immediate needs of the individual.

Referral Evaluation

The team reviews referrals from general psychiatric units, emergency departments, or community mental health teams. The referring party provides detailed information about the patient's psychiatric history, current symptoms, and any previous interventions.

Patient History

A comprehensive review of the patient's medical and psychiatric history is conducted, including any past admissions, treatments, and responses to medication.

Risk Assessment

A detailed risk assessment is performed to evaluate the potential risk of harm to the patient or others. This includes assessing the likelihood of self-harm, aggression, or suicidal ideation.

Physical Health Check

A physical health check is conducted to identify any medical issues that might affect psychiatric treatment or require concurrent medical attention.

Consent and Communication

Wherever possible, the patient is involved in the assessment process. Information about the PICU, its purpose, and the treatment approach is communicated to the patient and their family.

The PICU Environment

The environment within the PICU at Southern Hill Hospital is designed to promote safety, comfort, and healing. Key features of the unit include:

Secure and Safe Setting: The PICU is equipped with secure doors, windows, and surveillance systems to ensure the safety of patients and staff. The design of the unit minimises potential risks and provides a controlled environment.
Therapeutic Atmosphere: The unit is designed to create a calming and therapeutic environment. Natural light, soothing colours, and comfortable furnishings contribute to a sense of well-being.
Private Rooms: Patients are provided with private rooms to ensure their privacy and dignity. Each room is furnished to promote comfort and relaxation.
Common Areas: The PICU features communal areas where patients can engage in therapeutic activities, socialise, and participate in group sessions. These areas are designed to encourage interaction and support.
Outdoor Spaces: Access to outdoor spaces is provided to promote physical activity and a connection with nature. These areas are designed to be safe and secure, allowing patients to enjoy fresh air and outdoor activities.

Multidisciplinary Care Team

The PICU at Southern Hill Hospital is staffed by a dedicated and highly trained multidisciplinary team. The team works collaboratively to provide comprehensive and personalised care to each patient. Key members of the care team include:

Consultant psychiatrists lead the clinical team and are responsible for diagnosing and treating mental health conditions. They develop personalised treatment plans and oversee the overall care of patients.
Specialised mental health nurses provide round-the-clock care and support to patients. They administer medications, monitor symptoms, and offer therapeutic interventions.
Clinical psychologists conduct assessments and provide psychological therapies to help patients manage their symptoms and develop coping strategies.
Our Occupational Therapy Assistants (OTAs) work with patients to develop skills for daily living and promote engagement in meaningful activities. They help patients regain independence and improve their quality of life.
Support workers assist with day-to-day activities and provide additional support to patients. They help create a supportive and nurturing environment.

Treatment Approaches

The PICU at Southern Hill Hospital employs a range of evidence-based treatment approaches to address the diverse needs of patients. Treatment plans are tailored to each individual and may include the following:

Medication Management

Pharmacological treatment is a key component of care in the PICU. Psychiatrists prescribe and monitor medications to manage symptoms such as psychosis, depression, anxiety, and mood disorders.

Psychological Therapies

A variety of psychological therapies are offered, including cognitive-behavioural therapy (CBT), dialectical behaviour therapy (DBT), and mindfulness-based therapies. These therapies help patients develop coping strategies, improve emotional regulation, and address underlying issues.

Crisis Intervention

Immediate and intensive interventions are provided to manage acute psychiatric crises. The goal is to stabilise patients and reduce the severity of their symptoms.

Therapeutic Activities

A range of therapeutic activities are offered to promote engagement and well-being. These activities include art therapy, music therapy, and physical exercise.

Family Involvement

Family members are encouraged to be involved in the care and treatment of their loved ones. Family therapy sessions and support groups are available to help families understand and support the recovery process.

Discharge Planning

The multidisciplinary team works with patients to develop comprehensive discharge plans. This includes identifying appropriate community resources, arranging follow-up care, and ensuring a smooth transition to a less intensive level of care.

Patient Rights and Involvement

At Southern Hill Hospital, we are committed to respecting the rights of our patients and involving them in their care. Key principles include:

Informed Consent: Patients have the right to be informed about their treatment options and provide informed consent. Information is provided in a clear and understandable manner.
Confidentiality: Patient confidentiality is strictly maintained. Information is only shared with the patient's consent or when required by law.
Patient Participation: Patients are encouraged to participate actively in their treatment planning and decision-making. Their preferences and goals are considered in the development of their care plans.
Advocacy and Support: Advocacy services are available to help patients understand their rights and navigate the healthcare system. Support is provided to ensure patients' voices are heard.

Staff Training and Development

The staff at the PICU are highly trained professionals with specialised knowledge and skills in psychiatric care. Ongoing training and professional development are essential to maintaining high standards of care. Staff receive training in areas such as:

Risk Assessment and Management: Training in identifying and managing risks associated with acute psychiatric conditions.
De-escalation Techniques: Techniques for managing aggressive or agitated behaviour in a safe and therapeutic manner.
Therapeutic Communication: Skills for effective communication with patients experiencing severe psychiatric symptoms.
Trauma-Informed Care: Approaches to care that recognise and respond to the impact of trauma on mental health.
Cultural Competency: Training to ensure culturally sensitive and inclusive care for all patients.

Quality Improvement and Research

Southern Hill Hospital is committed to continuous quality improvement and advancing the field of psychiatric care. Initiatives include:

Clinical Audits

Regular audits of clinical practices to ensure adherence to best practice guidelines and identify areas for improvement.

Patient Feedback

Gathering feedback from patients and their families to inform service development and enhance the quality of care.

Research and Innovation

Participation in research studies and the implementation of innovative treatment approaches to improve patient outcomes.

Collaboration

Collaboration with other healthcare providers, academic institutions, and community organisations to share knowledge and best practices.

Challenges and Solutions

Providing care in a PICU presents several challenges. Southern Hill Hospital addresses these challenges through strategic initiatives and evidence-based practices:

Aggression and violence are common challenges in the PICU. Staff are trained in de-escalation techniques and the use of safe physical interventions when necessary. The therapeutic environment and structured activities also help reduce agitation and aggression.
Ensuring patient safety while respecting their autonomy can be challenging. Staff work closely with patients to develop personalised care plans that balance safety with individual preferences and goals.
PICUs require significant resources, including specialised staff and facilities. Southern Hill Hospital is committed to investing in the necessary resources to provide high-quality care.
Stigma and discrimination can impact patients' experiences and recovery. The hospital promotes a culture of respect, inclusion, and understanding to combat stigma and support patients' dignity.

Referral Process

Who Can Refer?

Referrals to the PICU can be made by a range of healthcare professionals, including:

Patient Flow Teams:: hospital bed management teams who identify patients in need of intensive psychiatric care.
Psychiatrists: Psychiatrists from acute psychiatric wards and HDU settings.
Section 136 Suite: Healthcare professionals in S136 dealing with acute psychiatric crises.
Community Mental Health Teams: CMHTs and CRHTTs providing mental health services in the community that identify individuals requiring a higher level of care.

Referral Documentation

Referrals should be accompanied by comprehensive documentation, including:

Patient Information: Full details of the patient, including demographic information, contact details, and next of kin.
Clinical History: A detailed account of the patient's psychiatric and medical history, including previous diagnoses, treatments, and hospitalisations.
Current Symptoms: A thorough description of the current psychiatric symptoms and the reasons for referral.
Risk Assessment: Information on any known risks, including history of violence, self-harm, or suicidal behaviour.
Treatment Summary: An overview of treatments and interventions that have been tried, including medication regimes and therapeutic interventions.
Supporting Documents: Any relevant reports, Nursing notes and assessments, or correspondence that can provide additional context.

At Southern Hill Hospital, we are dedicated to providing exceptional care for individuals experiencing severe psychiatric crises. Our PICU is a specialised unit designed to offer the highest level of psychiatric care in a safe, supportive, and therapeutic environment. We understand that the decision to seek intensive psychiatric care can be challenging for patients, families, and referring professionals. Our team is here to guide you through every step of the process with compassion and expertise.

For Patients and Families

If you or a loved one is experiencing a severe psychiatric crisis and require intensive care, please reach out to us. Our team at Southern Hill Hospital is here to provide the support and treatment needed to stabilise and begin the journey to recovery. You can contact our admissions team directly for more information about the PICU, the admission process, and what to expect.

For Referring Professionals

We value our partnerships with healthcare professionals in the community and other healthcare settings. Your collaboration is vital in ensuring that individuals in need receive timely and appropriate care. If you have a patient who you believe requires the specialised services of our PICU, please do not hesitate to refer them. Our team is available to discuss potential referrals, provide guidance on the necessary documentation, and facilitate a smooth admission process.