The place of Psychiatric Intensive Care Units (PICU) in care system

Psychiatric Intensive Care Units (PICU) are a recent creation in France. These facilities propose a secure setting for patients with acute behavioural disturbances difficult to manage in psychiatric general wards. Physical violence against other patients or hospital staff, substance abuse, non-compliance with care and treatment, intensity of symptoms or absconding are common motives for admission. Patient, are admitted from psychiatric facilities of a health-care area or by agreement between hospitals. Care and treatment must be centred on the patient, be Multidisciplinary, intensive, and comprehensive with an immediacy of response to critical situations. Interface and liaison with original services of patients are important issues as the length of stay should not exceed two months. In France, PICU exist at Cadillac, Lyon, Paris, Montpellier, Nice, Pau, Premontre and Eygurande. They are a missing link between psychiatric general wards and maximum security hospitals in the mental health care system. The report emphasizes the creation of an association, foreign experience and existence of national minimum standards. (C) 2009 Elsevier Masson SAS. All rights reserved.