A decentralised model of psychiatric care: Profile, length of stay and outcome of mental healthcare users admitted to a district-level public hospital in the Western Cape

Eileen Thomas, Karen Jacqueline Cloete, Martin Kidd, Helena Lategan


Background. There is a lack of studies assessing the profile and outcome of psychiatric patients at entry-level public hospitals that are prescribed by the Mental Health Care Act to provide a decentralised model of psychiatric care.

Objective. To assess the demographic and clinical profile as well as length of stay and outcomes of mental healthcare users admitted to a district-level public hospital in the Western Cape. 

Method. Demographic data, clinical diagnosis, length of stay, referral profile and outcomes of patients (N=487) admitted to Helderberg Hospital during the period 1 January 2011 - 31 December 2011 were collected. 

Results. Psychotic disorders were the most prevalent (n=287, 59%) diagnoses, while 228 (47%) of admission episodes had comorbid/secondary diagnoses. Substance use disorders were present in 184 (38%) of admission episodes, 37 (57%) of readmissions and 19 (61%) of abscondments. Most admission episodes (n=372, 76%) were discharged without referral to specialist/tertiary care. 

Conclusion. Methamphetamine use places a significant burden on the provision of mental healthcare services at entry-level care. Recommendations for improving service delivery at this district-level public hospital are provided.


District level hospital; Length of stay; Mental healthcare users; Psychiatry; Retrospective audit; South Africa

Full Text:


DOI: http://dx.doi.org/10.4102/sajpsychiatry.v21i1.538

Submitted: 05 December 2013
Published: 01 February 2015

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South African Journal of Psychiatry    |    ISSN: 1608-9685 (PRINT)    |    ISSN: 2078-6786 (ONLINE)