Clinical profile of acutely ill psychiatric patients admitted to a general hospital psychiatric unit.
OBJECTIVE
Helen Joseph Hospital in southern Gauteng Province is one of five specialist hospitals on the academic circuit of the University of theWitwatersrand. Against a background of new mental health legislation, implemented in South Africa during December 2004 with no formal mechanisms in place to monitor mental health services on different levels of care or in regions, a study with three objectives was undertaken, namely: (I) to provide a baseline on psychiatric morbidity and treatment outcome; (II) to establish the state of affairs analysis for mental health care and (III) to establish a framework for cost centre management. The current study focuses on objective one.


METHODS
A retrospective clinical audit was undertaken of mental health service delivery, teaching and research at Helen Joseph Hospital over a one-year period from September 2003 to August 2004. This article reports on the two service delivery datasets identified: the "Inpatient Discharge Summary Report" and the "Consultation/Liaison Report".


RESULTS
A total number of 438 service users were admitted and a monthly average of 80 consultation/liaison assessments was conducted during the study period. Persistent unfavourable nursing staff ratios continued, while the number of service users from other African countries was generally underrated. Non-compliance and substance abuse contributed significantly to the admission of service users. Schizophrenia was indicated as the most likely diagnosis in almost a quarter of cases.


CONCLUSIONS
Morbidity and treatment outcome at Helen Joseph Hospital will only be contextualized after the implementation of a regular clinical audit process in all the facilities of its referral network.
Janse van Rensburg
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Division of Psychiatry, University of the Witwatersrand, Johannesburg, South Africa.