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Audley Ward provides short periods of rapid assessment, intensive treatment and stabilisation for patients before or during a longer period of inpatient care. Admission will be based on an individual needs assessment and in some cases patients may be admitted directly to a PICU. 

Patients admitted to a PICU will have behavioural challenges which seriously compromise the physical or psychological well-being of themselves or others, and cannot be safely assessed or treated in an open acute inpatient facility (usually a general adult inpatient mental health ward).

Patients will only be admitted to a PICU if they display a significant risk of aggression, absconding with associated risk, suicide or vulnerability (e.g. due to sexual disinhibition or over-activity) in the context of a serious mental illness.

It is envisaged that all PICU patients would be detained under the Mental Health Act (MHA) 1983, as admission and detention in a locked PICU environment constitutes a fundamental loss of freedom for an individual. If a patient has been discharged from their MHA detention at short notice, there may be a short period of time during which they remain on the PICU informally until an onward care plan and pathway is arranged.

Audley PICU is a member of NAPICU and adheres to the NAPICU minimum standards and their admission criteria

Admission criteria for PICU

• Patients admitted to the PICU should exhibit mental state or clinical behaviour which seriously compromises their physical or psychological well-being, or that of others, and which cannot be safely assessed or treated in a general adult ward
• Externally directed aggression. A patient is assessed as posing a significant risk of harm to others or extreme aggression towards property
• Internally directed aggression. A patient is assessed as posing a significant risk of suicide and the patient is unresponsive to preventative measures available
• Absconding patients who are detained under the MHA 1983, for whom the consequences of persistent absconding are serious enough to warrant treatment in the PICU
• Unpredictably patients, potentially posing a significant risk to self or others and requiring further assessment
• Patients should be detained under the MHA 1983 (all section papers are checked before accepting admission) and patients are not admitted under section 136.

Admission exclusion criteria for PICU

• Patient is assessed as presenting too high an internal or perimeter security risk for the PICU, requiring a Medium or High secure PICU
• The patient has a primary diagnosis of Substance misuse and the primary purpose of admission is solely to prevent access to substances
• The patient has a primary diagnosis of Dementia or Learning Disability 
• Patients physical condition is too frail to allow their safe management on a PICU
• Patient has a chronic condition which would not benefit from admission to PICU
• The patient is restricted ( subject to MHA 1983 , via the courts ,Ministry of Justice) and has no clear pathway or provision for transfer from the PICU once clinically warranted
• Patient must be 18 years and over and not above 65 years.