Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-78c5997874-j824f Total loading time: 0 Render date: 2024-11-05T04:58:36.328Z Has data issue: false hasContentIssue false

Chapter 23 - Female-Only PICUs

Published online by Cambridge University Press:  15 March 2024

By
Joana Ferreira Marques de Paiva  and
Shanika Balachandra
Edited by
Roland Dix ,
Stephen Dye  and
Stephen M. Pereira
Roland Dix
Affiliation:
Gloucestershire Health and Care NHS Foundation Trust, Gloucester
Stephen Dye
Affiliation:
Norfolk and Suffolk Foundation Trust, Ipswich
Stephen M. Pereira
Affiliation:
Keats House, London
Get access

Summary

When psychiatric intensive care units (PICUs) were first created in the United Kingdom, they were mixed-sex wards. As time progressed, evidence grew stronger for the need to create separate PICUs for men and women. Female-only PICUs have been around for about a decade, making them a relatively novel phenomenon within the existing mental health services in the United Kingdom. Nevertheless, they play a crucial role within the wide net of mental health services. This chapter summarises the history and development of female-only PICUs and describes some female-specific characteristics of such wards. It then focuses on describing women-specific perinatal mental health presentations and services, including existing provisions for women with mental illness to access family support and contact with their children. Lastly, it discusses the clinical considerations for patients with EUPD and ASPD to access PICU settings.

Keywords

child and family services (CFS)emotionally unstable personality disorder (EUPD)psychiatric intensive care unit (PICU)female-only PICUgendermother-baby unit (MBU)postpartum depression (PPD)postpartum psychosis (PPP)
Type
Chapter
Information
Psychiatric Intensive Care , pp. 286 - 294
Publisher: Cambridge University Press
Print publication year: 2024

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Archer, M, Lau, Y and Sethi, F (2016) Women in Acute Psychiatric Units, Their Characteristics and Needs: A Review. BJPsych Bulletin 40: 266–72.CrossRefGoogle ScholarPubMed
Balachandra, S and Benson, V (2014) Men are from Mars, Women are from Venus. National Association of Psychiatric Intensive Care and Low-Secure Units – NAPICU – Local Quarterly Meetings 2016 Presentations. https://napicu.org.uk/membership/presentations/local-quarterly-meetings–2014/.Google Scholar
Bergink, V, Bouvy, PF, Vervoort, JSP, Koorengevel, KM, Steegers, EAP and Kushner, S. (2012) Prevention of Postpartum Psychosis and Mania in Women at Risk. American Journal of Psychiatry 169: 609–15.CrossRefGoogle Scholar
Bergink, V, Rasgon, N and Wisner, KL (2016) Postpartum Psychosis: Madness, Mania, and Melancholia in Motherhood. American Journal of Psychiatry 173: 1179–88.CrossRefGoogle ScholarPubMed
Bodner, E, Cohen-Fridela, S and Iancuc, I (2011) Staff Attitudes toward Patients with Borderline Personality Disorder. Comprehensive Psychiatry 52: 548–55.CrossRefGoogle ScholarPubMed
Bowers, L, Jeffery, D, Bilgin, H, Jarrett, M, Sympson, A and Jones, J (2008) Psychiatric Intensive Care Units: A Literature Review. International Journal of Social Psychiatry 54 (1) 56–68.CrossRefGoogle ScholarPubMed
Brown, S, Chhina, N and Dye, S (2008) The Psychiatric Intensive Care Unit: A Prospective Survey of Patient Demographics and Outcomes at Seven English PICUs. Journal of Psychiatric Intensive Care 4 (1–2) 17–27.CrossRefGoogle Scholar
Cullen, AE, Bowers, L, Khondoker, M, Pettit, S, Achilla, E, Koeser, L, et al. (2018) Factors Associated with Use of Psychiatric Intensive Care and Seclusion in Adult Inpatient Mental Health Services. Epidemiology and Psychiatric Sciences 27: 51–61.CrossRefGoogle ScholarPubMed
Doucet, S, Dennis, C, Letourneau, N and Robertson Blackmore, E (2009) Differentiation and Clinical Implications of Postpartum Depression and Postpartum Psychosis. Journal of Obstetric, Gynaecologic and Neonatal Nursing 38: 269–79.CrossRefGoogle ScholarPubMed
Dzikiti, C (2016) Introduction to NAPICU & the Commissioning of Female PICU Beds in England. National Association of Psychiatric Intensive Care and Low-Secure Units – NAPICU – Local Quarterly Meetings 2016 Presentations. https://napicu.org.uk/local-quarterly-meetings-2016-presentations/.Google Scholar
Elkin, A, Gilburt, H, Slade, M, Lloyd-Evans, B, Gregoire, A, Jhonson, S, et al. (2009) A National Survey of Psychiatric Mother and Baby Units in England. Psychiatric Services 60 (5) 629–33.CrossRefGoogle ScholarPubMed
Gillham, R and Wittkowski, A (2015) Outcomes for Women Admitted to a Mother and Baby Unit: A Systematic Review. International Journal of Women’s Health 7: 459–76.Google ScholarPubMed
Gintalaite-Bieliauskiene, K, Dixon, R and Bennett, L (2020) A Retrospective Survey of Care Provided to Patients with Borderline Personality Disorder Admitted to a Female Psychiatric Intensive Care Unit. Journal of Psychiatric Intensive Care 16 (1) 35–42.CrossRefGoogle Scholar
Griffiths, J, Taylor, BL, Morant, N, Bick, D, Howard, LM, Seneviratne, G, et al. (2019) A Qualitative Comparison of Experiences of Specialist Mother and Baby Units versus General Psychiatric Wards. BMC Psychiatry 19: 1–15. DOI: https://doi.org/10.1186/s12888-019-2389-8.CrossRefGoogle ScholarPubMed
Kohen, D (2001) Psychiatric Services for Women. Advances in Psychiatric Treatment 7: 328–34.CrossRefGoogle Scholar
Le, T, Bhushan, V, Sochat, M, Sylvester, P, Mehlman, M and Kallianos, K (2015) First Aid for the USMLE Step 1 2015: A Student-to-Student Guide. USA: McGraw Hill Education.Google Scholar
Lied, K, Zanarini, MC, Schmahl, C, Linehan, MM and Bohus, M (2004) Borderline Personality Disorder. Lancet 364: 453–61.Google Scholar
Linehan, MN and Heard, H (1999) Borderline Personality Disorder: Costs, Course, and Treatment Outcomes. In Miller, N and Magruder, K (eds.), The Cost-Effectiveness of Psychotherapy: A Guide for Practitioners, Researchers and Policy-Makers. New York: Oxford Press. pp. 291–305.Google Scholar
Livesley, JW (2003) Practical Management of Personality Disorder. London: Guilford Press.Google Scholar
Long, C, Hall, L, Craig, L, Mochty, U and Hollin, CR (2011) Women Referred for Medium Secure Inpatient Care: A Population Study Over a Six-Year Period. Journal of Psychiatric Intensive Care 7 (1) 17–26.CrossRefGoogle Scholar
McKay, A (2022) Bed Management Policy January 2019. Camden and Islington NHS Foundation Trust. www.candi.nhs.uk/sites/default/files/Bed%20Management%20Policy%20%20s140%20update%20November%202021.pdf.Google Scholar
Moran, P (1999) The Epidemiology of Antisocial Personality Disorder. Social Psychiatry and Psychiatric Epidemiology 34 (5) 231–42.CrossRefGoogle ScholarPubMed
Murray, L, Cooper, C and Hipwell, A (2003) Mental Health of Parents Caring for Infants. Archives of Women’s Mental Health 6 (2) 71–7.CrossRefGoogle ScholarPubMed
National Institute for Health and Care Excellence (NICE) (2013) Self-Harm. Quality Standard [QS34]. www.nice.org.uk/guidance/qs34.Google Scholar
National Institute for Health and Care Excellence (NICE) (2009) Antisocial Personality Disorder: Prevention and Management – Clinical Guideline 77 [CG77]. www.nice.org.uk/guidance/cg77.Google Scholar
O’Brien, A, Cramer, B, Rutherford, M and Attard, D (2013) A Retrospective Cohort Study Describing Admissions to a London Trust’s PICU Beds Over One Year: Do Men and Women Use PICU Differently? Journal of Psychiatric Intensive Care 9 (1) 33–9.Google Scholar
Paris, J (2004) Is Hospitalisation Useful for Suicidal Patients with Borderline Personality Disorder? Journal of Personality Disorders 18 (3) 240–7.CrossRefGoogle ScholarPubMed
Robertson, E, Celasun, N and Stewart, DE (2003) Risk Factors for Postpartum Depression. In Stewart, DE, Robertson, E, Dennis, C -L, Grace, SL and Wallington, T (eds.), Postpartum Depression: Literature Review of Risk Factors and Interventions. Toronto: University Health Network.Google Scholar
Royal College of Psychiatrists (RCPsych) (2018) Mother and Baby Units (MBUs). www.rcpsych.ac.uk/mental-health/treatments-and-wellbeing/mother-and-baby-units-(mbus).Google Scholar
Sadock, BJ and Sadock, VA (2010) Kaplan & Sadock’s Pocket Handbook of Clinical Psychiatry. USA: Lippincott Williams & Wilkins and Wolters Kluwer.Google Scholar
Satel, SL (1998) Are Women’s Health Needs Really Special? Psychiatric Services 49: 565. DOI: https://doi.org/10.1176/ps.49.5.565.CrossRefGoogle ScholarPubMed
Singleton, N, Coid, J, Bebbington, P, Jenkins, R, Brugha, T, Lewis, G, et al. (1998) The National Survey of Psychiatric Morbidity among Prisoners and the Future of Prison. London: The Stationery Office.Google Scholar
Sit, D, Rothschild, AJ and Wisner, KL (2006) A Review of Postpartum Psychosis. Journal of Women’s Health 15 (4) 352–68.CrossRefGoogle ScholarPubMed
Stapleton, A and Wright, N (2019) The Experiences of People With Borderline Personality Disorder Admitted to Acute Psychiatric Inpatient Wards: A Meta-Synthesis. Journal of Mental Health 28 (4) 443–57.CrossRefGoogle ScholarPubMed
Steinert, T, Lepping, P, Bernhardsgrütter, BR, Conca, A, Hatling, T, Janssen, W, et al. (2010) Incidence of Seclusion and Restraint in Psychiatric Hospitals: A Literature Review and Survey of International Trends. Social Psychiatry and Psychiatric Epidemiology 45 (9) 889–97.CrossRefGoogle ScholarPubMed
Stephenson, LA, Macdonald, AJD, Seneviratne, G, Waites, F and Pawlby, S (2018) Mother and Baby Units Matter: Improved Outcomes for Both. British Journal of Psychiatry Open 4: 119–25.CrossRefGoogle ScholarPubMed
Trull, TJ, Sher, KJ, Minks-Brown, C, Durbin, J and Burr, R (2000) Borderline Personality Disorder and Substance Use Disorders: A Review and Integration. Clinical Psychology Review 20 (2) 235–53.CrossRefGoogle ScholarPubMed
Weight, EJ and Kendal, S (2013) Staff Attitudes Towards Inpatients with Borderline Personality Disorder. Mental Health Practice 17 (3) 34–8.CrossRefGoogle Scholar
Widiger, TA and Weissman, MM (1991) Epidemiology of Borderline Personality Disorder. Hospital and Community Psychiatry 42 (10) 1015–21.Google ScholarPubMed
Woollaston, K and Hixenbaugh, P (2008) ‘Destructive Whirlwind’: Nurses’ Perceptions of Patients Diagnosed with Borderline Personality Disorder. Journal of Psychiatric and Mental Health Nursing 15 (9) 703–9.CrossRefGoogle ScholarPubMed
World Health Organization (WHO) (1992) The ICD-10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines. Geneva: WHO.Google Scholar
World Health Organization (WHO) (2010) WHO Technical Consultation on Postpartum and Postnatal Care. Geneva: WHO. p. 12. www.ncbi.nlm.nih.gov/books/NBK310595/.Google Scholar
Zanarini, MC, Frankenburg, FR, Hennen, J and Silk, KR (2003) The Longitudinal Course of Borderline Psychopathology: 6-Year Prospective Follow-Up of the Phenomenology of Borderline Personality Disorder. American Journal of Psychiatry 160: 274–83.CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×