Delayed discharges from a psychiatric intensive care unit – are we detaining patients unlawfully?

Onyon, Richard; Khan, Shahbaz Ali; George, Michelle

doi:10.1017/s1742646407000301

Cited by 3 publications

(1 citation statement)

References 6 publications

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“…In this study, five patients exceeded the NAPICU maximum eight-week stay guidance. Delayed discharge is considered a substantial issue within PICUs due to an increasing lack of bed spaces for ill individuals (Onyon et al 2007). The data collected for this study allowed us to investigate whether this is a particular issue.…”

Section: Introductionmentioning

confidence: 99%

The patient pathway outcomes of a female psychiatric intensive care unit

Learmonth¹,

Sethi²,

Christodoulou³

2017

j psych intensive care

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Background: Much of the literature on psychiatric intensive care units (PICU) examines either the treatment a patient receives or the unit's readmission rates. There is currently a lack of research into length of stay and patients' post-discharge outcomes or follow-up studies. Aims: This study explored the care pathway and patient outcomes six weeks post-discharge. Through examining patient care pathways, it was also possible to compare the length of stay at a female PICU against the Department of Health's guidance. Method: Patient data from internal records were gathered for patients who stayed at a South London PICU between October 2014 and March 2015; this equated to 50 female patient records. Results: At discharge, 86% of patients went to general acute treatment settings, 6% to home treatment teams, 4% to forensic services, 2% to a mother and baby unit and 2% to a private acute bed. At six weeks postdischarge 4% of patients had returned to the PICU, 52% were in the community, 36% were in acute treatment settings and 4% were absent without leave. Three patients exceeded the Department of Health's recommended maximum length of stay. Conclusions: The current care pathway appears to be successful in returning patients to the community within six weeks. Within the follow-up period over half of the patients had returned home, whilst a third were in general acute treatment settings.

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Section: Introductionmentioning

confidence: 99%

The patient pathway outcomes of a female psychiatric intensive care unit

Learmonth¹,

Sethi²,

Christodoulou³

2017

j psych intensive care

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An Integrative Review on Psychiatric Intensive Care

Salzmann-Erikson

2023

Issues in Mental Health Nursing

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Delayed discharge in inpatient psychiatric care: a systematic review

Teale,

Morgan,

Jenkins

et al. 2024

Int J Ment Health Syst

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Background Delayed discharge is problematic. It is financially costly and can create barriers to delivering best patient care, by preventing return to usual functioning and delaying admissions of others in need. This systematic review aimed to collate existing evidence on delayed discharge in psychiatric inpatient settings and to develop understanding of factors and outcomes of delays in these services. Methods A search of relevant literature published between 2002 and 2022 was conducted on Pubmed, PsycInfo and Embase. Studies of any design, which published data on delayed discharge from psychiatric inpatient care in high income countries were included. Studies examining child and adolescent, general medical or forensic settings were excluded. A narrative synthesis method was utilised. Quality of research was appraised using the Mixed Methods Appraisal Tool (MMAT). Results Eighteen studies from England, Canada, Australia, Ireland, and Norway met the inclusion criteria. Six main reasons for delayed discharge were identified: (1) accommodation needs, (2) challenges securing community or rehabilitation support, (3) funding difficulties, (4) family/carer factors, (5) forensic considerations and (6) person being out of area. Some demographic and clinical factors were also found to relate to delays, such as having a diagnosis of schizophrenia or other psychotic disorder, cognitive impairment, and increased service input prior to admission. Being unemployed and socially isolated were also linked to delays. Only one study commented on consequences of delays for patients, finding they experienced feelings of lack of choice and control. Four studies examined consequences on services, identifying high financial costs. Conclusion Overall, the findings suggest there are multiple interlinked factors relevant in delayed discharge that should be considered in practice and policy. Suggestions for future research are discussed, including investigating delayed discharge in other high-income countries, examining delayed discharge from child and forensic psychiatric settings, and exploring consequences of delays on patients and staff. We suggest that future research be consistent in terms used to define delayed discharge, to enhance the clarity of the evidence base. Review registration number on PROSPERO 292515. Date of registration 9th December 2021.

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Delayed discharges from a psychiatric intensive care unit – are we detaining patients unlawfully?

Cited by 3 publications

References 6 publications

The patient pathway outcomes of a female psychiatric intensive care unit

The patient pathway outcomes of a female psychiatric intensive care unit

An Integrative Review on Psychiatric Intensive Care

Delayed discharge in inpatient psychiatric care: a systematic review

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