Forensic Index and Substance Abuse among Psychiatric Patients

Abstract

Although forensic index and substance use are crucial issues in clinical work among mentally ill patients, studies emanating from psychiatric facilities in nonwestern cultures have been relatively scarce. This paper examines this issue in a tertiary health institution. Participants were 259 mentally ill patients (124 inpatients and 135 out-patients) drawn from University of Uyo Teaching Hospital, Uyo (UUTH) in Nigeria. Using a mixed method design, data were derived from a self-report questionnaire adapted from World Health Organization guidelines for substance use surveys, hospital folders and interviews. 169 (65.26%) patients used psychoactive substances while 90 (34.74%) not substance users. Reasons identified for drug use by the patients were to enhance performance (16%), ignorance of the risks involved (12.4%), due to the availability of substances (11.8%), because they are cheap (10.7%), and because many other patients use it (10.7%). Alcohol (14.20%) and cannabis (14.20%) were the most frequently used substances. Of the 169 drug users, 96.44% were brought by family members for treatment while others were brought by Nigerian Drug Law Enforcement Agency for rehabilitation (1.77%) and Court/Federal Road Safety Corps (.59%) for psychiatric rehabilitation. Thirty (17.8%) of the 169 patients with drug-related problems engaged in drug-related crimes but only 4 (13.3%) were reported and only 1 (3.3%) was prosecuted and punished. Intervention programmes in mental health facilities should include strategies for helping patients cope with drug use problems and proper attention should be paid to rehabilitation so as to wean such patients off substance misuse.

Key Words: Crime, forensic index, psychoactive drugs, rehabilitation, substance misuse.