A profile of adult acute admissions to Lentegeur Psychiatric Hospital, South Africa

Background Mental disorders and substance use disorders (SUD) commonly occur together, impacting healthcare outcomes. The diagnosis of substance use is often inadequate when comorbidity is present. It is vital to understand the prevalence of substance use amongst psychiatric patients to inform both clinical practice and service development in South Africa. Aim To ascertain the prevalence and clinical correlates of SUD amongst acute psychiatric inpatients. Setting The setting for this study was Helen Joseph Hospital acute psychiatric ward. Methods A cross-sectional study was conducted whereby consecutively admitted patients were invited to participate in a structured clinical interview utilising the alcohol use disorders identification test (AUDIT) and drug use disorders identification test (DUDIT) questionnaires. Statistical comparisons were made between those with and without SUD. Results Of 150 participants, 100 (67%) were identified with a SUD. Those with SUD were younger ( p = 0.0010), more often male ( p = 0.012), less likely to have a disability grant ( p = 0.015) and more likely to be brought to hospital by police, ambulance or self than by a family member ( p = 0.025). Almost half of people with bipolar disorder (47.3%) and schizophrenia (41.4%) had comorbid SUD. Twenty-three (15%) participants identified with SUD on questionnaire had been missed clinically. Only two participants were referred for inpatient substance rehabilitation on discharge. Conclusion Substance use disorders are highly prevalent amongst psychiatric inpatients. The AUDIT and DUDIT are potentially useful screening tools in routine clinical practice. Greater collaboration between psychiatric and substance rehabilitation services is recommended.

Section: Discussionsupporting

confidence: 83%

Prevalence and clinical correlates of substance use amongst acute psychiatric inpatients in Gauteng, South Africa

Anic

Robertson

2020

“…This pattern of education is not consistent with previous research in hospitalised MHCUs in South Africa, where it was noted that 63% of acute male admissions in Lentegeur Psychiatric Hospital in the Western Cape Province were educated to a secondary level. 16 When controlling for differences in level of education, there was no significant association with MCAT-V scores and group (MHCU vs. controls), suggesting that education level influenced total scores on the MCAT-V rather than membership of the group (MHCU vs. control). No previous associations have been reported between CAT-V scores and level of education.…”

Section: Discussionmentioning

confidence: 88%

An assessment of voting knowledge and related decisions amongst hospitalised mental healthcare users in South Africa

Marcus

Nel

2021

Background The South African Constitution protects the right to vote for every citizen. The Electoral Act (No. 73 of 1998) limits registration on the voter’s roll on the basis of being declared of ‘unsound mind’ or ‘mentally disordered’ by the high court or detention under the Mental Health Care Act (No. 17 of 2002). There is limited information regarding voting knowledge and subsequent voting-related decisions amongst South African involuntary mental healthcare users (MHCUs). Aim To compare voting knowledge and related decisions between hospitalised MHCUs and non-psychiatric hospitalised patients (controls). Setting Participants were recruited from Sterkfontein Psychiatric Hospital (MHCUs) and Chris Hani Baragawanth Academic Hospital orthopaedic wards (controls) in Gauteng, South Africa. Method A cross-sectional survey was conducted using a modified Cognitive Assessment Tool for Voting (MCAT-V) questionnaire. Scores on the MCAT-V were compared between the MHCU and control groups, along with socio-demographic variables and clinical variables. Results There was a significant association between group (MHCU vs. control) and HLOE ( p = 0.016). Although the median overall score for the controls (11; interquartile range [IQR] 10–12) was significantly higher than that for the MHCUs (10; IQR 8–12) ( p = 0.043), when controlling for education level, there was no significant association between group (MHCU/control) and MCAT-V scores ( p = 0.011). The MCAT-V scores of the ‘Doe questions’ between the MHCUs and controls were not significantly different ( p = 0.063). There was a difference in ‘reasoning scores’ between MHCUs and controls ( p = 0.0082) and this was associated with level of educational attainment ( p = 0.013). Conclusion The limitations regarding voter registration legislated in the South African Electoral Act , are not supported by the findings of this study. The MCAT-V demonstrates a possible educational bias and therefore is not recommended as a screening tool for assessing voting competency.

“…The high levels of secondary stress and burnout may be because of the nature of mental healthcare which includes being exposed to the trauma associated with mental illness, 4 frequent involuntarily admissions of MHCUs 4 and exposure to aggressive behaviour from MHCUs. 30 Other studies have also reported the high secondary traumatic stress related to being assaulted by MHCUs. 13 , 31 , 32 …”

Section: Discussionmentioning

confidence: 98%

Professional quality of life amongst nurses in psychiatric observation units

Maila

Martin

Chipps

2020

Background: Professional quality of life amongst nurses in psychiatric observations units may be affected by working conditions such as an overflow of mental health care users (MHCUs), a shortage of nurses, lack of specialised staff and inadequate infrastructure to accommodate MHCUs amongst others.Aim: The aim of the study was to investigate the professional quality of life amongst nurses in psychiatric observation units.Setting: The study was conducted in psychiatric observation units in eight hospitals in the Metropole District Health Services in the Western Cape.Method: A quantitative descriptive survey design using the Professional Quality of Life (ProQoL version 5) questionnaire was conducted with an all-inclusive sample of 175 nurses. The ProQoL has two scales, namely, the compassion satisfaction and the compassion fatigue. Compassion fatigue includes two subscales, burnout and secondary traumatic stress. Ethics to conduct the study was obtained from the Research Ethics Committee at the university and the Department of Health in the Western Cape.Results: A response rate of 93% (n = 163) was obtained. Respondents reported moderate compassion satisfaction. Psychiatric nurse specialists and registered nurses reported lower compassion satisfaction than enrolled nurses and nursing assistants. This came with moderate levels of burnout and high levels of secondary traumatic stress, with enrolled nurses and enrolled nursing assistants reporting lower levels than the other professional groups.Conclusion: Psychiatric nurse specialists and registered nurses experienced higher burnout and secondary traumatic stress and lower compassion satisfaction than the lower categories of nurses.