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n South African Journal of Psychiatry - 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
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.
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