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.


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


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


METHODS
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.
Smith
A D
AD
Institute of Criminology, University of Cambridge.
Humphreys
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006778:Hospitals, Psychiatric / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology; D008875:Middle Aged; D010360:Patient Transfer / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012606:Scotland; D012637:Security Measures; D014754:Violence / Q000523:psychology