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Integration and specialism: complementary not contradictory

Published online by Cambridge University Press:  19 January 2007

Stephen Pereira
Affiliation:
Consultant Psychiatrist, Pathways Psychiatric Intensive Care Unit; Honorary Senior Lecturer, Guy's, King's & St Thomas' School of Medicine; Chairman, NAPICU
Daniel Dalton
Affiliation:
Consultant Psychiatrist, Pathways Psychiatric Intensive Care Unit; Honorary Senior Lecturer, Guy's, King's & St Thomas' School of Medicine; Chairman, NAPICU

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Psychiatry, behavioural disturbance and risk management have conceptually coexisted for hundreds of years, however, prior to the 1800 Criminal Lunatics Act, drafted exigently following an attempt on the life of the then King by the “insane” Hadfield, the only means of care was custodial, under arcane vagrancy legislation, such as the 1714 Vagrancy Act, or on the basis of the poor laws. Mentally disordered individuals were either incarcerated as criminals or paupers (Select Committee, 1807) falling under the responsibility of local parish councils. At this point, incarceration was just that, with prisons hosting most detained mentally disordered individuals, under the indefinite see of the monarch. The first vision for caring, secure, environments for mentally disordered individuals was in the development of asylums following the 1808 County Asylums Act, which recognised that detaining, “lunatics and other insane persons…in Gaols, Houses of Correction, Poor Houses and Houses of Industry, is highly dangerous and inconvenient.

Type
Editorial
Copyright
© 2006 NAPICU

References

Beer, M.D., Paton, C. and Pereira, S. (1997) Hot beds of general psychiatry: a national survey of psychiatric intensivecare units. Psychiatric Bulletin. 21(3): 142144.Google Scholar
Brown, S. and Bass, N. (2004) The psychiatric intensive care unit (PICU): patient characteristics, treatment and outcome. Journal of Mental Health (UK). 13(6): 601609.Google Scholar
Brown, K. and Wellman, N. (1998) Psychiatric intensive care: a developing speciality. Nursing Standard. 12(29): 4547.Google Scholar
Butler Report (1975) Report of the Committee on Mentally Abnormal Offenders, CMND 6244. HMSO, London.
County Asylums Act (1808) An Act for the Better Care and Maintenance of Lunatics, being Paupers or Criminals in England. HMSO, London.
Crowhurst, N. and Bowers, L. (2002) Philosophy, care and treatment on the psychiatric intensive care unit: themes, trends and future practice. Journal of Psychiatric and Mental Health Nursing. 9(6): 689695.Google Scholar
Department of Health (1975) Better Services for the Mentally Ill.A White Paper. HMSO, London.
Department of Health (1999) National Service Framework for Mental Health. Modern Standards and Service Models. HMSO, London.
Department of Health (2001) Mental Health Policy Implementation Guide, Acute Adult Care Provision, pp. 10 & 24. HMSO, London.
Department of Health (2001) Mental Health Policy Implementation Guide, National Minimum Standards for General Adult Services in Psychiatric Intensive Care Units and Low Secure Environments. HMSO, London.
Dye, S. and Johnston, A. (2005) After the standards … a gaping cavity filled by clinical governance? Journal Of Psychiatric Intensive Care. 1(1): 35.Google Scholar
Glancy Report (1974) Working Party Report on security in the NHS, Psychiatric Hospitals. HMSO, London.
Goldney, R.,et al.(1985) The psychiatric intensive care unit. British Journal of Psychiatry. 146: 5054.Google Scholar
NACRO (2005) Findings of the 2004 Survey of Court Diversion/Criminal Justice Mental Health Liaison Schemes for Mentally Disordered Offenders in England and Wales, March 2005. http://nacro.org.uk
National Institute for Clinical Excellence (2005) Clinical Guidance 25: Violence, The Short-Term Management of Disturbed/Violent Behaviour in Inpatient Psychiatric Settings and Emergency Departments, ISBN 1-84257-921-5. NICE.
Pereira, S., Sarsam, M., Bhui, K. et al. (2005) The London survey of psychiatric intensive care units: service provision and operational characteristive of national health service units. Journal of Psychiatric Intensive Care. 1(1): 715.Google Scholar
Pereira, S., Beer, M. and Paton, C. (1997) Good Practice Issues In Psychiatric Intensive Care Units. Psychiatric Bulletin. 23(7): 397400.Google Scholar
Pereira, S., Beer, D. and Paton, C. (2001) Psychiatric intensive care, ISBN: 1-900151-87-1. Greenwich Medical Media Limited, London, England.
Rachlin, S. (1973) On the need for a closed ward in an open hospital: the psychiatric intensive-care unit. Hospital & Community Psychiatry. 24(12): 829833.Google Scholar
Reed Report (1992) Report into Mentally Disordered Offenders and Others Who Require Similar Services (CM2088). HMSO, London.
Roberts, A. (1981) Mental Health History Timeline; at http://www.mdx.ac.uk/www/study/MHHTim.htm
Select Committee of the House of Commons (1807) To Inquire into the State of the Criminal and Pauper Lunatics in England and Wales, and the Laws Relating Thereto, PP 1807 (39) vol 2, p. 69. HMSO, London.
Select committee of the House of Commons (1815) Report on Madhouses in England PP 1814–1815 (296) vol 4, pp 801–1034. HMSO, London.
Zigmond, A. (1995) Special care wards: are they special? Psychiatric Bulletin. 19: 310312.Google Scholar