In 1991, the first Medical Psychiatric Unit (MPU) in Australia was est
ablished at the Royal Prince Alfred Hospital, Sydney. The processes in
volved in introducing it to the hospital staff and administration, as
well as its structure and criteria for admission, are described. Its d
evelopment 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 Psych
iatric 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 t
he complexity of treatment procedures, the MPU patients' duration of s
tay was similar to the GPU patients'. The MPU was found to have achiev
ed goals of clinical and cost-effectiveness. It has become an establis
hed subunit within the Department of Psychiatry.