Background: The Western Cape province has the highest documented lifetime prevalence of common mental disorders in South Africa. To ensure the efficient, equitable and effective distribution of current resources, there is a need to determine the profile of patients requiring psychiatric admission.Aim: To describe patients admitted to the acute adult admissions unit at Lentegeur Hospital.Setting: Lentegeur Psychiatric Hospital is situated in Mitchells Plain, Cape Town, and serves about 1 million people from nearby urban and rural areas.Methods: This retrospective study involved an audit of all patients (18–60 years of age) admitted between 01 January 2016 and 30 June 2016. The clinical records of 573 adult patients were examined.Results: The median age of the cohort was 29 years. Most patients (63%) were educated to the secondary level. Only 12% of the patients were employed, and 37% received disability grants. More than 90% of the patients presented with psychotic symptoms. Of these, 28% presented with a first-episode of psychosis. Of all patients, 20% were referred with manic symptoms and 7% with depressive symptoms. Many patients (62%) used substances concurrently in the period leading up to admission. Significantly more males (73%) used substances compared to females (38%). Cannabis was the most widely used substance (51%), followed by methamphetamine (36%). Recent violent behaviour contributed to 37% of the current admissions. A total of 70 patients (13%) tested positive for human immunodeficiency virus (HIV), and 49 (9%) tested positive for syphilis.Conclusion: Substance use and a history of violence contributed to admissions in this population.
Background and objectiveThe prevalence of mental illness and illicit substance use has increased markedly in South Africa's Western Cape Province, over the last 2 decades; potentially increasing demand for psychiatric care. This paper describes the demographic and substance use profile of patients admitted to Lentegeur (LGH), the largest of the four psychiatric hospitals in the Province.MethodsMedical records, patient interviews and other clinical notes were used to collect data on demographics, illicit substance use, violent behaviour and utilization of rehabilitative services for patients (n=535) admitted to LGH between 1 August 2012 and 31 January 2013.ResultsMajority of admissions were male (65.6%) and younger (69.8% < 35 years) compared to females (62.6% >35 years). Overall, 255 (49%) used an illicit substance, (24% females and 63% males). Majority of substance users were youth (18–35 years) in both males (83.1%) and females (73.8%). Cannabis and methamphetamine were the most popular drugs in males (56.3% and 34.9%) and females (17.9% and 16.2%) with the highest rates being among the youth. Violence was common among both men (60.7%) and women (40.8%); among the violent, 67% of males and 35.6% of female used substances. Only 5.5% of drug users utilized formal drug rehabilitation services.ConclusionSubstance use and violence were high, yet only a small proportion of the patients utilised available drug rehabilitation services. This may have implications on psychotic relapses, morbidity and subsequent pressure on financial resources within the health care system. Efforts are needed to maximise utilisation of existing rehabilitative resources for these patients.
IntroductionThe Western Cape Province has the highest documented lifetime prevalence of common mental disorders in South Africa. To ensure the efficient, equitable and effective distribution of current resources, there is a need to determine the profile of patients seeking psychiatric treatment.AimThe aim of this study was to describe patients admitted to the Acute Adult Admissions Unit at Lentegeur Hospital (LGH) which is situated in Mitchells Plain, Cape Town.MethodsThis retrospective study involved an audit of all patients (18–60 years of age) admitted between 01 January 2016 and 30 June 2016.ResultsA total of 573 adult psychiatric patients were profiled. The median age of the cohort was 29 years. The majority of patients (63%) were educated to the secondary level. Only 12% of patients were employed and 37% received disability grants. More than 90% of cases presented with psychotic symptoms. Of these, 28% presented with first episode psychosis. Of all patients, 20% were referred with manic symptoms and 7% with depressive symptoms. Many patients (62%) used substances in the period leading up to admission. Significantly more males (73%) used substances compared to females. Cannabis was the most widely used substance (51%), followed by methamphetamine (36%). Violence was a contributing factor to 37% of admissions. A total of 70 patients (13%) tested positive for HIV, while 49 (9%) tested positive for syphilis.ConclusionWe found the average patient requiring admission to be a young urban male who would likely have a secondary level (grades 8–12) education, but be unemployed. This patient would also likely be a user of illicit substances, would present psychotic and would likely display violent behaviour prior to referral. Substance use and a propensity for violence were identified as significant factors that influence the likelihood of admission. We invite planners in the Department of Health, as well as other stakeholders, to take heed of this burgeoning crisis and to implement specific strategies for addressing these problems before the effectiveness of mental health services as a whole is further undermined.
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