Exploring Patients Service Experience of Psychiatric Intensive Care Unit (PICU) Admissions

Background: A psychiatric intensive care unit (PICU) is a tertiary mental health service that provides short-term care for patients who present with highly challenging behaviours during their psychiatric admission and require close supervision and observation due to their elevated risk of self-harm and harm towards others. A key feature of a PICU is its high level of staffing and more secured facilities. The main purpose of a PICU admission is to optimise management of patients who pose a risk to themselves and others whilst benefiting from a low-stimulus environment. However, the body of knowledge that sub serves the perspective of patients’ ‘service experience’ regarding PICU admissions remains relatively unexplored. Objective: The purpose of this study is to explore patients’ service experience of PICU admissions with the hope that this will help improve service delivery on these wards/units. Methods: The study employed a descriptive qualitative research approach. Data for this study was collected using a semi-structured questionnaire over a six-month period. The study participants involved psychiatric patients admitted to PICU under the Irish Mental Health Act of 2001 legislation from other approved centres in Ireland. Results: Six themes emerged from participants’ responses namely, communication and therapeutic engagement, unit environment, recreational and activity therapies, privacy and confidentiality, access to information as well as general experience of care and service provision in PICU. The results provide moderately less evidence for the engagement of PICU patients in recreational activities during the period of admission in PICU. Additionally, there was significantly inadequate pre-discharge debriefing for patients prior to discharge from PICU. Lastly, a greater proportion of the study participants were satisfied with PICU services and expressed their willingness to recommend PICU to individuals who may benefit from PICU services. Conclusion: Understanding the experiences of this patient population and their perspectives on PICU services is crucial to informing and developing concrete strategies for clinical practice in acute psychiatric settings. Therefore, therapeutic programs and more flexible activities are required to facilitate easy access by patients that will enhance or positively shape their experiences of PICU and other acute psychiatric services.