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Delayed discharges from a psychiatric intensive care unit – are we detaining patients unlawfully?

  • R Onyon (a1), S Khan (a1) and M George (a1)


Background: The principle that patients should be cared for under conditions of no greater security than is justified is well established and applies to patients cared for on psychiatric intensive care units.

Aims: This audit aimed to establish: (1) the characteristics of patients admitted to a PICU, (2) whether patients experienced delays in discharge to care in lower levels of security and (3) the characteristics of patients who experienced a delayed discharge.

Method: An audit survey of the case notes of patients discharged from an inner city PICU in 2005 to establish compliance with the standards described.

Results: Of 109 patients discharged from the PICU, 88 were included in the survey. 51.1% of patients experienced a delay in discharge from the PICU. The characteristics of the patients discharged from the PICU are described, and compared with those experiencing a delay in discharge.

Conclusions: Patients often experience a delay in discharge to clinically appropriate levels of security from a typical PICU. The source of referral of patients and diagnosis are associated with a delay in discharge. The findings warrant wider study.


Corresponding author

Correspondence to: Dr Richard Onyon, Specialist Registrar, Queen Elizabeth Psychiatric Hospital, Edgbaston, Birmingham, B15 2QZ, UK. Tel: 0121 678 2007; E-mail:


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Beer, D., Spiller, M.J., Pickard, M., Gravestock, S., McGovern, P., Leese, M., Turk, V., Brooks, D. and Bouras, N. (2005) Low secure units: Factors predicting delayed discharge. Journal of Forensic Psychology and Psychiatry. 16(4): 621637.
Barlow, K., Grenyer, B. and Ilkiw-Lavalle, O. (2000) Prevalence and precipitants of aggression in psychiatric inpatient units. Australian and New Zealand Journal of Psychiatry. 34: 967974.
Brooke, D. (1998) Patients with a learning disability at Kneesworth House Hospital. Psychiatric Bulletin. 22: 2932.
Central Office for Research Ethics Committees (2001) Governance Arrangements for NHS Research Ethics Committees. London: Department of Health.
Department of Health and Home Office (1992) Review of Health and Social Services for Mentally Disordered Offenders and Others Requiring Similar Services. Final Summary Report. London: The Stationery Office.
Department of Health and Welsh Office (1999) Mental Health Act 1983 Code of Practice. London: The Stationery Office.
Department of Health (2000) National Service Framework for Mental Health. London: Department of Health.
Greengross, P., Hollander, D. and Stanton, R. (2000) Pressure on adult acute psychiatric beds. Psychiatric Bulletin. 24: 5456.
Maden, A., Curle, C., Meux, C., Burrow, S. and Gunn, J. (1995) The Treatment and Security Needs of Special Hospital Patients. London: Whurr.
Office for National Statistics (2006) Neighbourhood Statistics, Birmingham (Local Authority), Ethnic Group – Percentages.
Pereira, S.M., et al. (2005) The London Survey of Psychiatric Intensive Care Units: psychiatric intensive care, patient characteristics and pathways for admission and discharge. Journal of Psychiatric Intensive Care. 1: 1724.
Reed, J. (1997) Review of Health and Social Services for Mentally Disordered Offenders and Others Requiring Similar Services. Vol. 2: Service Needs. London: The Stationery Office.
Sharpley, M., et al. (2001) Understanding the excess of psychosis among the African-Caribbean population in England: review of current Hypotheses. British Journal of Psychiatry – Supplementum. 40: s60s68.



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