Decision Units

What is a Mental Health Decision Unit?

They offer a space for further assessment for people in mental health crisis, to decide which services would be best suited: whether that’s admission to an inpatient ward or signposting to services in the community, as well as providing therapeutic input. The decision units are nurse-led, and patients may receive brief psychosocial interventions, for example around techniques for coping under extreme stress or resilience.

There is the option of overnight stay, though this tends to be with reclining chairs rather than beds as found on a ward. Stays are generally limited to between 1-3 days.

If you’d like to learn more, this recent documentary explores life on Lotus, a Decision Unit in South West London.

How are patients referred to a Decision Unit?

A patient might have been referred from a range of services, such as from A&E (Liaison Psychiatry), Street Triage, crisis resolution and home treatment. Currently, patients cannot self-refer.

Why were Decision Units introduced?

They were primarily introduced to ease the pressure on A&E and inpatient psychiatric wards. Mental health A&E admissions have increased and people often wait there for a long time while bed occupancy on inpatient psychiatric wards is inappropriately high. Decision Units offer a midway point to either discharging someone home or admitting them to an inpatient ward, with the aim of reducing unnecessary admissions as well as keeping A&E wait times down.

Why haven’t I heard of a Decision Unit?

Decision Units are not particularly well-known as most have only opened in the past few years in response to the growing demand on mental health crisis services. They are also called different names e.g. Crisis Assessment Unit and Psychiatric Decision Unit. This project is the first large multi-site evaluation of Decision Units.