Psychiatric Intensive Care Unit

Written by Fox.

We've been in many different types of unit, but up until several months ago we'd never been in psychiatric intensive care aka PICU. So what is a PICU like?

We had been in the open rehab for a few months. In September last year we went downhill very quickly. On Keri's daughter's anniversary Sally absconded and ended up being brought back by police after she ended up at Keri's birth mother's again. The staff dealt with it. What they couldn't deal with a few weeks later was Keri's risk to herself. She was suicidal. And I mean acutely. She had to be placed on 1:1 observation (a member of staff with her at all times) and a few days later we were all told that we were going to be transferred to psychiatric intensive care due to the high risk.

We were sat in our room and Keri was talking to her 1:1. The deputy manager came upstairs and told us we were going to be transferred. They grabbed a bag of her stuff and we went downstairs, where 4 members of staff from the PICU were waiting. Obviously they'd been expecting trouble. They were right to. Keri panicked. As soon as she stepped out of the door she tried to make a break for it and ended up restrained until we got to the PICU (which was only a 5 minute walk across the hospital grounds).

When we first arrived on the unit, we were taken through an airlock and into a secluded area. All of us were on red alert due to the fact we'd never been in intensive care. Sally was ready to explode at any threatening opportunity. Keri was strip searched and had literally everything taken away and was given a set of hospital pyjamas with no pockets or any hidey holes. This meant that her and Sally's razors that Sally had hidden in the lining of Keri's tracksuit bottoms were found due to the metal detector they used.

We were shown around the unit. It was the bare minimum. Intensive care units are classed as 'low stimulus' which means there is literally nothing there to distract you except the TV, and at that point none of us had the concentration to focus on it anyway. We were shown to our room and put on 5 minute observations (a member of staff had to check on us literally every 5 minutes). If anything this was worse than 1:1. At least with 1:1 you know someone is there constantly so you know there is no point whatsoever in trying to do anything. However, if you're on 5 minutes, you have that freedom to self-harm or try and kill yourself but you also know that if it takes more than 5 minutes then you're going to get caught pretty quickly.

Due to Keri's state of mind, even a minute alone was enough for her to try stuff. Headbanging, punching walls, trying to choke herself on tissue paper (which was also restricted, you had to ask for toilet paper every time you went to the toilet). The unit also triggered off Penny. Penny ligatured a couple of times in the secure unit but in intensive care she was doing it every chance she got. Keri only did it a couple of times in the beginning, the rest of the time it was Penny. Penny is also suicidal so it's not a great combination to have.

At one point Keri and Penny had ligatured so many times in the space of several hours that the only thing the staff could do was to strip us of everything and put Keri in an anti-ligature suit. This is a suit that is made of material that can't be ripped. It's basically shorts and t-shirt in the same material that Keri's anti-ligature blanket was made out of (she wasn't allowed a duvet or pillow due to her risk). We were all freezing while we were stuck in that suit.

Sally came out a couple of times so we did end up in seclusion at one stage. Sally kicked a member of staff in the back and ended up being dragged to seclusion. What made her even worse was the fact that the staff had to restrain her while also taking off her clothes and underwear to put her in an anti-ligature suit just in case Penny came out while we were stuck in seclusion. Despite Keri switching back out after about an hour we were kept in there for over 4 hours. It was horrible and, for Sally, humiliating.

We spent about a month there before we stepped down to an acute ward (which is A LOT less restrictive). We weren't allowed to make our own drinks and were given lukewarm drinks every hour in paper cups. The garden was open for 10 minutes an hour for people to smoke and between midnight and 6am it was kept shut so no smoking allowed unless you had a restless night. If you did then they allowed you one 'discretional cigarette' in that time period.

Overall we never want to go there again. It was worse than the secure unit. It was degrading and humiliating. The things the staff had to do were last resorts and were to keep us safe but it didn't stop us feeling like our dignity was completely taken away. Even Sally felt ashamed when they had to strip her off in seclusion and that, of course, made her worse.

PICUs are a last resort when someone is critically unwell, for instance being acutely suicidal or dangerous because you're very psychotic. It's not a very good environment to be in at any time, but personally I think it's even worse that very unwell people are put in those kinds of units. It's all well and good keeping them safe from themselves or other people safe from them but there's no distraction or stimulus. It's an environment that you can literally do nothing except brood and reflect, and you end up trapped in your own head. If we ever end up in a place like that again, Sally has already said she'll stay out constantly to protect us all as she sees it as a constant threat. I honestly cannot blame her for thinking like this, but realistically it would mean we'd end up being kept in there a lot longer.