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The psychiatric decision unit as an emerging model in mental health crisis care: a national survey in England
Author(s) -
Goldsmith Lucy P.,
Anderson Katie,
Clarke Geraldine,
Crowe Chloe,
Jarman Heather,
Johnson Sonia,
LloydEvans Brynmor,
Lomani Jo,
McDaid David,
Park ALa,
Smith Jared A.,
Turner Kati,
Gillard Steve
Publication year - 2021
Publication title -
international journal of mental health nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.911
H-Index - 54
eISSN - 1447-0349
pISSN - 1445-8330
DOI - 10.1111/inm.12849
Subject(s) - mental health , referral , mental healthcare , medicine , unit (ring theory) , health care , nursing , service (business) , psychiatry , psychology , business , political science , mathematics education , marketing , law
Psychiatric decision units have been developed in many countries internationally to address the pressure on inpatient services and dissatisfactory, long waits people in mental health crisis can experience in emergency departments. Research into these units lags behind their development, as they are implemented by healthcare providers to address these problems. This is the first‐ever national survey to identify their prevalence, structure, activities, and contextual setting within health services, in order to provide a robust basis for future research. The response rate was high (94%), and six PDUs in England were identified. The results indicated that PDUs open 24/7, accept only voluntary patients, provide recliner chairs for sleeping rather than beds, and limit stays to 12–72 hours. PDUs are predominantly staffed by senior, qualified mental health nurses and healthcare assistants, with psychiatry input. Staff:patient ratios are high (1:2.1 during the day shift). Differences in PDU structure and activities (including referral pathway, length of stay, and staff:patient ratios) were identified, suggesting the optimal configuration for PDUs has not yet been established. Further research into the efficacy of this innovation is needed; PDUs potentially have a role in an integrated crisis care pathway which provides a variety of care options to service users.