Who we can help

Heygate Ward is a highly staffed unit which 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.

Heygate 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

Our team are expert in treating people with acute mental illness and complex needs, offering a range of group and individual therapeutic interventions to meet the patients’ needs at different stages of their recovery, including:

• Psychological skills
• Mindfulness
• Problem solving
• Mental health awareness, including: understanding stress, understanding medication, substance misuse and understanding unusual experiences (psychosis).

Once risk is reduced and the patient’s mental state and behaviour has been stabilised, transfer to an appropriate facility will take place – we focus on moving individuals on to these services and back in to less secure or community settings as soon as possible.

Heygate Ward uses medication led model and follows the nursing approach of Safewards which incorporates:

• clear mutual expectations
• soft words
• reassurance
• mutual help meeting
• bad news mitigation
• positive words
• calm down methods
• discharge messages
• talk down
• know each other.

Depending on their mental state, patients will be engaged on a suitable OT programme to facilitate recovery.  These groups are facilitated by Occupational Therapists, Psychology, Nursing, with sessions also by the Physical Health Nurse, Art Therapist and Advocacy.

Facilities

• Modern bedrooms with en-suite bathrooms
• Therapy areas including crafts, information technology (IT) skills, kitchens and vocational rehabilitation
• Fitness suite
• Large enclosed courtyard and garden
• Children and family visitor room
• Multi-faith room
• GP
• Café
• Library 
• Chillax Room.

Next steps 

Discharge is considered at admission and our clinical and social work teams work with appropriate case managers to support a transition.