Original Research

A decentralised model of psychiatric care: Profile, length of stay and outcome of mental healthcare users admitted to a district-level public hospital in the Western Cape

Eileen Thomas, Karen Jacqueline Cloete, Martin Kidd, Helena Lategan
South African Journal of Psychiatry | Vol 21, No 1 | a538 | DOI: https://doi.org/10.4102/sajpsychiatry.v21i1.538 | © 2015 Eileen Thomas, Karen Jacqueline Cloete, Martin Kidd, Helena Lategan | This work is licensed under CC Attribution 4.0
Submitted: 05 December 2013 | Published: 01 February 2015

About the author(s)

Eileen Thomas, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa, South Africa
Karen Jacqueline Cloete, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa, South Africa
Martin Kidd, Centre for Statistical Consultation, Stellenbosch University, Cape Town, South Africa, South Africa
Helena Lategan, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa, South Africa

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Abstract

Background. There is a lack of studies assessing the profile and outcome of psychiatric patients at entry-level public hospitals that are prescribed by the Mental Health Care Act to provide a decentralised model of psychiatric care.

Objective. To assess the demographic and clinical profile as well as length of stay and outcomes of mental healthcare users admitted to a district-level public hospital in the Western Cape. 

Method. Demographic data, clinical diagnosis, length of stay, referral profile and outcomes of patients (N=487) admitted to Helderberg Hospital during the period 1 January 2011 - 31 December 2011 were collected. 

Results. Psychotic disorders were the most prevalent (n=287, 59%) diagnoses, while 228 (47%) of admission episodes had comorbid/secondary diagnoses. Substance use disorders were present in 184 (38%) of admission episodes, 37 (57%) of readmissions and 19 (61%) of abscondments. Most admission episodes (n=372, 76%) were discharged without referral to specialist/tertiary care. 

Conclusion. Methamphetamine use places a significant burden on the provision of mental healthcare services at entry-level care. Recommendations for improving service delivery at this district-level public hospital are provided.


Keywords

District level hospital; Length of stay; Mental healthcare users; Psychiatry; Retrospective audit; South Africa

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