Profile of male acute admissions at a state psychiatric hospital in the Western Cape, South Africa

Abstract

Background: Inpatient psychiatric services in South Africa are faced with challenges such as high demand for beds, rapid discharges, limited community services upon discharge and high readmission rates.
Aim: To provide a profile of the demographic and clinical characteristics of the mental health users of inpatient male acute psychiatric services.
Setting: The male acute unit at Stikland Hospital.
Methods: A retrospective folder review of all patients discharged (n = 693) from the male acute psychiatric unit at Stikland Hospital between 01 February 2022 and 31 January 2023, and followed up for 1 year post-discharge.
Results: Most of the admissions were young males (29 [23–35] years), single (89%) and unemployed (80.8%), with no secondary-level education (65.4%). Thirty per cent of admissions were admitted directly to the unit, and most patients presented with a diagnosis of schizophrenia (42.1%). Almost half (47.8%) of all admissions were patients previously admitted to Stikland Hospital, and more than one quarter (27.6%) were readmitted within 1 year following discharge. Most admissions had a short length of stay (36 [27–53] days) and were crisis-discharged (63.5%). The use of long-acting injectables (LAI) was highly prevalent (73.4%).
Conclusion: Current inpatient psychiatric services are functioning as crisis intervention units. The study provides a foundation for developing context-specific, tailored strategies to be integrated into the discharge planning processes within the existing healthcare system.
Contribution: Current system-related factors, such as bed shortages, lead to short length-of-stays (LOS) and crisis discharges, which likely contribute to a higher rate of readmissions.