Abstract

ObjectivesThe objective of this research was to determine regional aspects (such as clinical, geographic and socio-demographic) influencing the use of public sector long-term psychiatric services in the Eastern Cape. This is important in improving service delivery, to assist policy developers with evidence-based research and in providing equitable and efficient resource utilisation.MethodologyA situational analysis of Tower Psychiatric Hospital and Psychosocial Rehabilitation Centre (TPHPRC) in the Eastern Cape was conducted. Patient administrative data were utilised to determine geographic origin, date and age at admission, gender and diagnosis as of December 2015. The number of admissions from each region for the years 2010–2015 was also extracted from these data.ResultsAs of December 2015, there were a total of 390 patients at TPHPRC. Of these, 87% were male patients. The average age at admission for male and female patients was 36 years and 44 years, respectively. Of the patients, 53% originated from the western regions and 57% of female patients presented with a dual diagnosis. The highest number of admissions was in 2015, with the majority originating from Port Elizabeth.ConclusionDespite higher access to public psychiatric care in the western region, the majority of patients originated from there. Contributing factors to this include diagnoses, insufficient bed numbers and the absence of admission criteria and referral pathways. It is recommended that the provincial Department of Health set up a task team to determine a standardised working framework for all public sector psychiatric institutions. This should be informed by national policies, legislation and provincial norms and indicators.

Highlights

  • The World Health Assembly adopted the Comprehensive Mental Health Action Plan 2013–2020 in May 2013.1 This plan has at its core to improve mental health in all 194 member states by 2020

  • The results of this research show a higher number of admissions from the western compared to the eastern regions of the province, despite a higher access to public sector mental health services in the western region.[6]

  • In the Eastern Cape, the South African Index for Multiple Deprivation[11] shows that the wards most deprived in terms of material possessions, social and human capital, decent housing, basic services and poverty are in the eastern regions, in the former Transkei, and the least deprived wards are centred around the two nodes of economic development, viz. Port Elizabeth and East London

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Summary

Introduction

The World Health Assembly adopted the Comprehensive Mental Health Action Plan 2013–2020 in May 2013.1 This plan has at its core to improve mental health in all 194 member states by 2020. South Africa’s National Mental Health and Policy Framework[2] aims to ensure that mental health services are equitable, comprehensive and integrated at all levels of the health system It advocates a move away from long-term psychiatric care towards the development of community psychiatry within a 7-year period. Prior to rapid deinstitutionalisation, it would be important to investigate the current utilisation of long-term psychiatric care provincially, the origin, demographic profile and reasons associated for admission. This information will provide the foundation for the development of an accessible community psychiatric service, which is as close to where patients reside. It will inform the development of adjunctive services, such as substance-abuse rehabilitation centres, ambulatory services and child and adolescent facilities

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