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The psychiatric decision unit as an emerging model in mental health crisis care: a national survey in England

Goldsmith, L., Anderson, K., Clarke, G. , Crowe, C., Jarman, H., Johnson, S., Lloyd-Evans, B., Lomani, J., McDaid, D., Park, A-L., Smith, J. A., Turner, K. & Gillard, S. ORCID: 0000-0002-9686-2232 (2021). The psychiatric decision unit as an emerging model in mental health crisis care: a national survey in England. International Journal Of Mental Health Nursing, 30(4), pp. 955-962. doi: 10.1111/inm.12849


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.

Publication Type: Article
Additional Information: © 2021 The Authors. International Journal of Mental Health Nursing published by John Wiley & Sons Australia, Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Publisher Keywords: crisis care, crisis unit, emergency, mental health decision units, psychiatric decision unit
Subjects: B Philosophy. Psychology. Religion > BF Psychology
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
Departments: School of Health & Psychological Sciences > Nursing
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