Aims Children and adolescents may require admission to PICU to manage significant episodes of psychiatric or behavioural disorders. The primary aim was to determine the number of paediatric psychiatry patients requiring PICU admission and the indications for admission. Methods Our patient information system was used to identify patients admitted with a psychiatric presentation. Results Fifteen patients were admitted during the study period. Ten (66%) patients were admitted at a weekend and 12 (80%) were admitted after 5pm. The admitting diagnosis was self-harm in 7 (46%), psychosis in five (33%) and an eating disorder in three (20%) patients. Conclusion The number of patients requiring PICU admission was small but represents a significant challenge to staff and resources. There is a need to establish a governance structure and pathway of care for these patients.