Characteristics of in-patients transferred to a locked ward in a Scottish psychiatric hospital.

OBJECTIVE

To identify and characterise in-patients transferred from open wards to the locked facility (IPCU) of a psychiatric teaching hospital, and to classify reasons for transfer.

DESIGN

Retrospective case note study using the Lothian Psychiatric Case Register. A reason for transfer classification was devised.

SETTING

Intensive Psychiatric Care Unit (IPCU) of the Royal Edinburgh Hospital.

SUBJECTS: All in-patients transferred from other wards of the Royal Edinburgh Hospital to the IPCU during one year.

RESULTS

Over one year there were 131 transfer episodes involving 97 patients. Ninety-eight per cent of episodes could be allocated to one of six categories of reason for transfer, with physical violence to others being commonest (30%). Patients' mean age was 31 years. There was a predominance of schizophrenics (51%) and males (66%). In 20% of transfers, patients were not detained under mental health legislation. Associations emerged between schizophrenia and physical violence, hypomania/mania and generally disruptive behaviour, personality disorder and self harm. In half of all transfers the patient had already been an in-patient for at least 1 month. Fifty-seven per cent of patients were transferred more than once over the preceding five years. Most (90%) transfers originated from acute wards, and patients stayed in the IPCU less than two weeks (70%) before returning to the open wards (23% less than 24 hours).

CONCLUSIONS

Local locked wards deal with a range of disturbed behaviour and can be an important component in the spectrum of secure provision. Further evaluative research is required.