Evolution and evaluation of a medical psychiatric unit.

In 1991, the first Medical Psychiatric Unit (MPU) in Australia was established at the Royal Prince Alfred Hospital, Sydney. The processes involved in introducing it to the hospital staff and administration, as well as its structure and criteria for admission, are described. Its development was compared to the experiences of others in North America over the past 15 years. The functioning of the MPU over the subsequent 2 years was evaluated by assessing demographic and clinical criteria of patients admitted. Data were obtained from patient medical records and compared with similar data on patients admitted to a General Psychiatric Unit (GPU). It was found that patients of the MPU tended to be older, more often male, and suffering from organic brain syndromes and/or alcohol or drug abuse. Despite the multiplicity of diagnoses and the complexity of treatment procedures, the MPU patients' duration of stay was similar to the GPU patients'. The MPU was found to have achieved goals of clinical and cost-effectiveness. It has become an established subunit within the Department of Psychiatry.