Psychiatric Intensive Care Service

It is a 4 bed service integrated clinically and geographically within the Alfred Psychiatry Ground Floor inpatient unit.

Service delivery options for patients referred to APICSS consist of:

• bed based care at Alfred Psychiatry
• secondary consultation and support for the referring mental health service which may be onsite or phone based

The goals of care are:

• stabilisation of acute symptoms and behavioural difficulty that have made treatment difficult at the referring service
• expert, short-term, individualised care in a safe, secure and therapeutic environment
• best practice multidisciplinary care, including psychiatry, nursing and allied health to facilitate supported return of the patient to the referring service as soon as appropriate

Patients must be:

• in an acute phase of a major psychiatric illness (most commonly psychosis or mania) that is likely to benefit from APICSS hospital care
• non-responsive to assertive treatment strategies implemented by referring AMHS
• have associated behavioural disturbances that prevent appropriate provision of therapy
• able to be safely integrated and managed with other Alfred APICSS patients

Referral process

Access to this service is through referral from the inpatient treating team at a Victorian Area Mental Health service.

To refer the AMHS Nurse Manager should phone Alfred Psychiatry Ground Floor Nurse Manager to discuss referral on (03) 9076 3912.

APICSS Referral Form is to be completed by Senior Registrar or Consultant from the referring service and should include:

1. rationale for APICSS
2. expected goals of admission
3. clinical history
4. AMHS Key Contacts
5. relevant assessments/supporting information
6. medication history

and should be faxed to Alfred APICSS Consultant and Alfred APICSS Nurse Manager on (03) 9076 3916

Once a referral is received, the APICSS team will meet to discuss the referral and contact the referring team to clarify and identify any further information needed. The APICSS team will then contact AMHS and discuss the outcome of the referral. This may include:

• Admission
• Secondary consultation
• Visit to referring service by APICSS team to assess patient
• Recommendation for alternative service

For accepted admissions, before transfer a Referral Decision Letter will be faxed to APICSS with signed acceptance of conditions of care from Director of referring AMHS.

Please note a condition of admission is that: when the patient is stabilised they will be transferred back to the referring IPU and the referring AMHS will accept responsibility for the discharge plan. Time and transfer arrangements will then organised in discussion between APICSS and AMHS staff. Admission to The Alfred will be planned to occur during business hours to ensure the safety of the patient and Alfred staff

If no bed is available the patient will be put on a waiting list with AMHS. The referrer will be contacted when the bed is available and referral appropriateness reassessed.