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National services

Child and adolescent services

National services

Child and adolescent services

National services

Child and adolescent services

National services

Child and adolescent services

Child and Adolescent Psychiatric Intensive Care Unit (PICU)

 Bethlem Royal Hospital

Contact information:

Denis Hill Unit
Bethlem Royal Hospital
Monks Orchard Road

020 3228 4220 or 020 3228 4757



Referrals are accepted from:

  • Community child and adolescent mental health services (CAMHS) and youth justice diversion schemes following assessment by Tier 3 CAMHS consultant (or ST4-6 if waiting for a consultant assessment would result in a significant delay)
  • Community CAMHS includes adolescent outreach services, early intervention in psychosis services, community adolescent forensic service or an adult mental health service if they provide care for 16 to 18 year olds
  • Specialist residential settings including secure children’s homes where the referral has been made by a CAMHS consultant or ST4-6 and only for children on welfare legislation under the Children Act 1989, and who may be liable for detention under the Mental Health Act 1983
  • Tier 4 general adolescent and low secure inpatient services

Key areas: Young people admitted to the PICU beds will generally fall into one of two broad categories:
  • Complex behavioural presentations, which may arise from affective or psychotic symptoms, learning disability or autism spectrum disorder; high-risk behaviours such as assaulting others, frequent absconding, forensic history and current risk including sexual behaviours
  • Serious self-harm, which are extreme, and potentially life threatening where all efforts to maintain safety on an open unit have failed

Average length of inpatient treatment: Six to eight weeks


We are a psychiatric intensive care unit (PICU) for adolescents between the ages of 12 to 18 years old. Our unit is part of the South London Partnership, and is located within the heart of south London at the Bethlem Royal Hospital.

The CAMHS Adolescent PICU is an eight-bedded mixed-sex unit for young people with an acute mental health illness who cannot be safely cared for on a general adolescent unit.

Our unit provides short, focused admissions (six to eight weeks) to decrease the level of risk so that the young person may be transferred back to a less restrictive environment.

We treat young people experiencing severe mental health problems, and who require a hospital admission within a more intensive and secure setting. All of the young people admitted to our unit will be detained under the Mental Health Act 1983.

Should the young person’s level of risks exceed that which can be safely managed on a PICU, or their level of risk is continuing beyond a reasonable period, they may be transferred to a low or medium secure unit for on-going treatment.

We offer a broad range of treatments, including medication, cognitive behaviour therapy, group work, psycho educational family work, systemic family work and art psychotherapy. Our multidisciplinary team is made up of psychiatrists, psychologists, nurses, teachers, occupational therapists, social workers and other therapists.

A 24-hour, seven day a week emergency admission service is offered for both new presentations to services via A&E, the police, or for those requiring transfer from general adolescent units within the South London Partnership.

We maintain close links with the person’s referring team to ensure they experience a smooth transition back to the local general adolescent unit or in some cases straight to the community. Our ward is part of the larger CAMHS inpatient care pathway across the South London Partnership, which includes crisis care, generic adolescent inpatient care and a supported discharge service.

The South London Partnership (SLP) is a collaboration between South London and Maudsley NHS Foundation Trust, Oxleas NHS Foundation Trust and South West London and St George’s NHS Foundation Trust. The SLP aims to provide a local Tier 4 CAMHS provision across South London to avoid admissions out of area to private hospitals.