Non-forensic secure services for adolescents: what are we talking about?

There is considerable variability in the ethos of the various adolescent in-patient units in Britain. Currently, there are few services within NHS settings able to manage acute behavioural disturbance in adolescents despite the prevalence of psychiatric disorder in this population group. Due to this variation, individual units around the country have developed their own bespoke services for managing disturbance. These services are given different names although may be operating with similar models. However, there is little consensus on these definitions, resulting in services with similar titles providing differing levels of service and varying capacity to manage violence or aggression. We attempt to define patient populations in need of such services and suggest a nomenclature for defining such services that could be universally adopted. We also describe the five-year review of admissions of one adolescent psychiatric intensive care unit and suggest how well its name fits with our proposed model.