Child and Adolescent Mental Health Services: regional Intensive Psychiatric Care Unit service specification

Tier 4 CAMHS Psychiatric Intensive Care Unit (IPCU)

Introduction

These principles and standards of care refer to Intensive Psychiatric Care Unit (IPCU) provision for Child and Adolescent Mental Health Services (CAMHS) to be delivered within a clearly defined geographical area at regional level, with service configuration determined locally based on population needs and existing service provision for Tier 4 CAMHS.

How the service is connected to other CAMHS services

Three regional adolescent Inpatient Unit (IPU) providers (NHS Tayside, Lothian and Greater Glasgow & Clyde (GGC)) are planning regional IPCUs for adolescents on behalf of boards in each region. Planning and data collection pertaining to recognition of need should continue across all regions.

Regional IPCUs will connect to the provision of other community-based regional services via standards and pathways; and to National IPUs via standards and pathways and agreed admission and discharge planning protocols.

Boards will provide local Tier 3 CAMHS services to the standards of the National CAMHS Service Specification ^[1].

Regions will provide specialist hubs delivering Intensive Home Treatment Teams (IHTT), Learning Disability CAMHS (LDCAMHS), Forensic CAMHS, and CAMHS in Secure Care.

Definitions / Criteria

Medium secure, low secure, and IPCU services provide a range of physical, procedural, and relational security measures not required in general inpatient units to ensure effective treatment and care whilst providing for the safety of young people, staff and the public.

General adolescent IPUs provide inpatient care without the need for enhanced physical or procedural security measures.

IPCUs manage short-term behavioural disturbances which cannot be contained within a general adolescent service. Behaviour will include a serious risk of either suicide, absconding with a significant threat to the safety of self and or others, aggression, or vulnerability due to agitation or sexual disinhibition. Levels of physical, relational, and procedural security should be the same as in low security.

Low secure IPU will accommodate young people with mental and neurodevelopmental disorders at lower but significant levels of physical, relational, and procedural security. The average length of admission would be considerably longer than any admission to an IPCU which as outlined above would be only for short term management of acute behavioural disturbance.