I am delighted to be able to recommend this book to clinicians working at all levels of the multidisciplinary team in psychiatric intensive care, low secure, medium secure and general hospital psychiatry.

Psychiatric intensive care units (PICUs), have now been with us for some 20 years or more and, in that time, have refined and defined their role within the various levels of care offered by individual mental health care trusts. Most patients in the UK have access to intensive care and the importance of this area is emphasised by the continuance and strengthening of the National Association of Psychiatric Intensive Care Units (NAPICU) and the successful founding of the International Journal of Psychiatric Intensive Care. The editors of this edition have all been pivotally involved in these developments.

The PICU stands at the interface point between these different levels of care and is often the cornerstone of effective management of the most unwell and difficult to treat within the psychiatrically unwell population. All of those working within this field are consistently faced with complex issues that cut across ordinary boundaries of care. In addition, the biopsychosocial management of PICU patients, from the first break to the chronically treatment resistant, requires the individual practitioner to have access to, and knowledge of, the fullest therapeutic armamentarium.

The first edition of this book published in 2001, represented the ‘first definitive and authoritive text in the subject (of PICUs)’, and, covered, ‘all aspects of the specialty from techniques for rapid tranquillisation through to physical, risk and management issues, as well as interfaces with forensic services’.