Clinical profile of acutely ill psychiatric patients admitted to a general hospital psychiatric unit

Rensburg, A B R Janse van

doi:10.4314/ajpsy.v10i3.30248

Cited by 13 publications

(17 citation statements)

References 7 publications

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“…Although a description and assessment of the program and of expenditure was included in reports to local hospital and academic management at the time 1,2 , only the data on the clinical profile of the acute in-patients at HJH was published previously. 3,4 Following implementation of the MHCA, this follow-up review was undertaken of a four-year period (2004)(2005)(2006)(2007) of mental health care activity and outcome at HJH, reviewing service delivery, teaching and research. Where the pilot study for example offered only a provisional and proportional calculation of expenditure, the purpose of this follow-up study was to provide a more detailed review of mental health care activity and outcome at this facility, employing activity-based costing as a method to do a cost centre analysis of recurrent cost.…”

Section: Introductionmentioning

confidence: 99%

Acute mental health care and South African mental health legislation Part 1- morbidity, treatment and outcome

Rensburg¹

2011

Afr. J. Psych

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This is the first of three reports on a follow-up review of mental health care at Helen Joseph Hospital (HJH). In this first part, qualitative and quantitative descriptions were made of the services and of demographic and clinical data on acute mental health care users managed at HJH, in a retrospective review of clinical records over a four year period. Objectives for this review were to provide information on mental health care outcome, to do a cost analysis and to establish a quality assurance cycle that may facilitate a cost centre management approach. The operational areas identified were service delivery, teaching, and research. Activities within each area were in-patient care, outpatients and consultation/liaison, under-and postgraduate teaching and self initiated or contract research. Method: The study reviewed the existing mental health care program and activities in context of relevant policy and legislation. Results: Norms from a World Health Organization model for acute mental health care showed that significant staff shortages existed, especially for nursing. A total of 520 users were admitted for in-patient mental health care during the financial year 2007/08. The average length of stay was 15.4 days and ranged from 1 to 85 days. Ninety users (17%) had an extended period of stay of 25 days and more, while 39 users had multiple admissions during the 12 month period. The most common Axis I diagnoses made were schizophrenia n=138 (29%), substance-related conditions n=99 (21%) and bipolar mood disorder n=69 (14%). After discharge, 139 users (27%) were referred back to the HJH outpatient department for follow-up. Conclusion: The information from these reports may be used in the allocation of adequate resources to align this acute unit with its responsibilities according to recent legislation.

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Section: Introductionmentioning

confidence: 99%

Acute mental health care and South African mental health legislation Part 1- morbidity, treatment and outcome

Rensburg¹

2011

Afr. J. Psych

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“…The HIV prevalence rate in the current study of 11.3% is substantially lower than the HIV prevalence rate in mental healthcare users in other South African studies that range from 23.8% to 44%. 21,22,23 It is of concern that the HIV status of 22.6% of the patients was unknown. This may be because of challenges with obtaining informed consent with some mental healthcare users, but may also be because of an inadequate HIV screening policy.…”

Section: Discussionmentioning

confidence: 99%

A retrospective chart review of clinical characteristics and magnetic resonance imaging findings of patients from a psychiatric facility in KwaZulu-Natal province, South Africa

Juby

Paruk

2019

South African Journal of Psychiatry

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BackgroundMany neurological conditions manifest with psychiatric symptoms and may be misdiagnosed. Structural neuroimaging, that is, computerised tomography (CT) and magnetic resonance imaging (MRI), can aid in the diagnosis or exclusion of these conditions. Magnetic resonance imaging is preferable in this regard, but is more expensive and less readily available than CT. The indications for requesting MRI in the clinical psychiatric setting remain poorly defined. All published literature on the clinical utility of neuroimaging in Africa is on CT scans.AimThe aim of this study was to describe the clinical characteristics and MRI findings in a cohort of patients presenting with psychiatric symptoms.SettingA specialist psychiatric training hospital, Townhill Hospital, in Pietermaritzburg, KwaZulu-Natal.MethodsA retrospective chart review of all patients who underwent MRI between 01 October 2010 and 31 June 2016 was done. Magnetic resonance imaging findings were correlated with socio-demographic and clinical information, including psychiatric diagnosis, indication for MRI imaging and effect on clinical management.ResultsFifty-three MRIs were performed. Thirty-three (62%) were abnormal. Patients with HIV, neurocognitive disorders, chronic mental illness and involuntary admission were more likely to have abnormal scans (83%, p = 0.089; 80%, p = 0.496; 71%, p = 0.089 and 79%, p = 0.021, respectively). The findings of 54% of abnormal MRIs (24% of all MRIs performed) resulted in referral to other disciplines. No statistically significant associations were found with socio-demographic or clinical factors.ConclusionAbnormalities on MRI scans in mentally ill patients were common and a quarter of patients required referral to other disciplines. Further studies are required to clarify the clinical utility of MRI in patients with psychiatric illness, which could assist in the development of a guide for the rational use of this modality in a resource-constrained environment.

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“…Meehan et al 6 postulate that the potential absconder is a young single male schizophrenic who comes from a disadvantaged background. However, these patients are more likely to be admitted to inpatient psychiatric services 7,8 leading to an over-representation of these characteristics. Absconding rates vary widely (2.5% – 34% of all psychiatric patients) because of the different definitions 5 and calculations used.…”

Section: Introductionmentioning

confidence: 99%

Absconding from a psychiatric hospital in Johannesburg, South Africa: Are we seeing a decrease since the implementation of the Mental Healthcare Act?

Arbee¹,

Subramaney

2019

S. Afr. J. Psych.

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BackgroundAbsconding from psychiatric facilities, the aetiology and impact of which have major socio-economic implications, has a multifactorial aetiological basis. Absconding patients are at higher risk of self-harm, violence, non-adherence, relapses, substance use and negative media attention. Most health professionals associate absconding with the escape of potentially dangerous psychiatric patients. Absconding causes fear and uncertainty, and portrays psychiatric services negatively. Identification of potential absconders would assist with risk assessment and prevention.AimThe aim of this study was to formulate an absconding rate as well as a descriptive profile of absconders since the inception of democracy and deinstitutionalisation.SettingThe study was conducted at Sterkfontein Hospital, a specialised psychiatric hospital outside Johannesburg.MethodsA retrospective record review of absconders from Sterkfontein Hospital in Johannesburg over 1 year was conducted.ResultsThe absconding rate was 7.83%. The characteristics of the typical absconder included single, unemployed male, early 30s, known to psychiatric services, diagnosed with schizophrenia and co-morbid substance use. An absconder is more likely to be a forensic patient not returning from official leave of absence.ConclusionThe absconding rate has decreased to less than half that of a previous study, and is within international norms. While the descriptive profile is of limited value, it does appear that psychiatric patients are being treated in a less restrictive manner resulting in fewer absconders and a change in the method of absconding. The implications for clinical practice are firstly that a clearer definition of the term absconding is needed as this will impact risk assessment and management. It is recommended that future studies separate forensic and general populations. Lastly, the formulation and use of a risk assessment tool may be of value.

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Clinical profile of acutely ill psychiatric patients admitted to a general hospital psychiatric unit

Abstract: Objectives: Helen Joseph Hospital in southern Gauteng Province is one of five specialist hospitals on the academic circuit of

Cited by 13 publications

References 7 publications

Acute mental health care and South African mental health legislation Part 1- morbidity, treatment and outcome

Acute mental health care and South African mental health legislation Part 1- morbidity, treatment and outcome

A retrospective chart review of clinical characteristics and magnetic resonance imaging findings of patients from a psychiatric facility in KwaZulu-Natal province, South Africa

Absconding from a psychiatric hospital in Johannesburg, South Africa: Are we seeing a decrease since the implementation of the Mental Healthcare Act?

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