PICU / Acute

Our national network of PICUs cater for emergency admissions for men and women experiencing an acute period of mental illness that cannot be managed in an open acute inpatient setting. All admissions are detained under the Mental Health Act. Referrals come to us from all areas including acute services, prison, or via the criminal justice system.

The focus of our PICUs is stabilisation, and moving individuals as quickly as possible to the most appropriate and least restrictive environment, whilst avoiding the need for readmission. This is achieved through the provision of a short term intensive assessment and treatment programme, designed to support service users to regain a sense of control and order in their lives so they can ultimately return home.

The men and women we support come to us in crisis, and often present with very complex needs and increased risks that compromise their physical or psychological wellbeing, or that of others. We can also assess and transfer urgent prison referrals swiftly. Our teams work closely and collaboratively with service users, their families and the referrer to provide a seamless pathway from referral to discharge.

Care and treatment in a PICU is person-centred and delivered by a comprehensive multi-disciplinary team. There is an emphasis on the use of relational security, safety, recovery programmes and pharmacology in the management of risk, challenging behaviour and enduring mental health disorders. Training, coaching and supervision of staff enable the clinical team to remain knowledgeable and skilled in the provision of modern, appropriate, compassionate and safe care to service users.

Our PICU and acute wards work closely together to form comprehensive acute care pathways across the group. Working closely with commissioning teams, we are able to offer pathways out of PICU where clinically appropriate and therapeutically beneficial, across our comprehensive network of specialist services, including acute services, mental health rehabilitation and specialist personality disorder or neuropsychiatric services.

Our acute inpatient psychiatric services provide a safe and stabilising environment for men and women who are in crisis, experiencing an acute episode of mental illness and requiring an emergency admission. Service users may be informal or detained under the Mental Health Act.

The ethos across our services is about assessing and treating individuals in the least restrictive environment and planning for discharge in a robust and timely fashion. With a focus on stabilisation, we support service users to manage their mental health, reinforce daily living skills and prepare for independent life back in the community.

Our teams work closely and collaboratively with the people we support, their families and the referrer to provide a seamless pathway from referral to discharge. Our approach is recovery focused and supported by comprehensive multi-disciplinary teams, contributing to shorter lengths of stay.

Our short-term psychological interventions are based on a Cognitive Behavioural Therapy (CBT) approach and we also provide specialist substance misuse support and psychoeducation, alongside a comprehensive occupational therapy programme.

Due to the robust environment at our services, we are able to actively support service users at the challenging end of the acute spectrum, without requiring admission to a PICU service.
We work closely with NHS referring teams to keep lengths of stay as short as possible and to ideally discharge individuals home, or move them back to a less restrictive environment.

Our PICU and acute wards work closely together to form comprehensive acute care pathways across the group. Working closely with commissioning teams, we are able to offer pathways out of PICU where clinically appropriate and therapeutically beneficial, across our comprehensive network of specialist services, including acute services, mental health rehabilitation and specialist personality disorder services.

myPath is our unique overarching care model that serves to monitor service user engagement levels, manage their records, assess individual progress and formulate a personalised and dynamic care plan with measurable targets. Within our PICU and acute services, myPath is structured to support short term admissions for those individuals who have a mental illness and also require preparation for independent life within the community, or for moving into mainstream rehabilitation.

For each individual, a daily risk assessment is completed, which enables dynamic responses to individual presentation within any 24 hour period and ensures immediate support is provided. Each individual is offered a minimum of 25 hours meaningful activity, which is evidenced and documented within an individualised activity timetable based around understanding mental health needs and developing daily living skills. All individuals’ care pathways are reviewed in full by the multi-disciplinary team on a weekly basis and guided by a dynamic care plan that is closely linked to our specialist outcome tool, the Global Assessment of Progress (GAP).

In our PICU and acute services, the GAP allows us to measure an individual’s progress during their admission, plot the positive developments and changes in wellbeing whilst formulating plans over potential future risks for longer term management. In applying myPath, our team is able to be responsive in their approach, determine length of stay, and ensure that people can move as quickly as possible to the most appropriate and least restrictive environment.

PICU stands for Psychiatric Intensive Care Unit.

A PICU is a supportive inpatient service for people experiencing a mental health crisis who need immediate, specialist care in a hospital setting.

In most cases, people are cared for on a PICU because they have been detained under the Mental Health Act, meaning they need treatment to help them stay safe and well.

Specialist teams follow national and professional guidance to ensure high-quality, compassionate care. PICUs are designed to provide short term, intensive support, helping individuals to stabilise so they can return to a less restrictive environment – such as an acute ward – and in some cases directly back to the community.

Our PICUs offer rapid intervention to help each person move forward with their recovery. We always aim to work closely with family members and carers, collaborating as a team to meet the needs of everyone we care for.

An acute mental health ward provides inpatient treatment and care for people experiencing severe mental health difficulties. On acute wards, the people admitted might be detained under the Mental Health Act, or they might be informal patients, which means they have chosen to come into hospital voluntarily to engage with treatment.

A PICU is designed for people who need more intensive support for a short period of time. This is because their symptoms require a more secure, safe and closely supported environment.

Acute wards provide a less intensive level of support, but still offer structured care, treatment, and monitoring.

People may move between PICU and acute services depending on how their mental health progresses, ensuring they are always in the place that best supports their recovery.

PICU and Acute services are designed to provide intensive and short-term treatment. Every person is unique, but usually, people stay on one of these wards for around a month; this can be longer or shorter, depending on what each person needs to get better.

To access a PICU or Acute mental health service, speak to an NHS professional. This could include: a member of the crisis team, a care coordinator or an A&E doctor or nurse. For information about local support in a crisis, call 111.