Community-oriented services in a psychiatric hospital. Effort to reduce stigmatization

Abstract

Mental illnesses are highly stigmatized worldwide;in Nigeria, the psychiatric
institutions and the mental health personnel are additionally stigmatized. From its inception
as an asylum about a century ago, Psychiatric Hospital, Yaba Lagos has had its own share of
stigmatization. For instance the observed fear of the citizenry to enter into the hospital
premises, as well as its being derogatorily labeled as “Ogba were” (lunatic asylum) and
“Yaba apa osi” (Yaba to the left side). Consequently, in the year 2000 the hospital stepped
up its efforts on destigmatization through public enlightenment programmes and provision
of commercial /social as well as general health care services in the institution that would
bring or attract the citizenry to its facilities
We carried out an audit study of the utilization of general health care services
provided within the hospital partly aimed at attracting the citizenry to the hospital premises
such as Harvey Road Community Clinic (HRCC): a general health care practice and
Electroencephalograph(EEG)unit. Furthermore, the statistics of patients\' flow to the
hospital 5 years before the year 2000 (when destigmatization programme was reorganized
in the hospital) and five years after was done.
Necessary consent was obtained from the Research and Ethical Committee of the
hospital to carry out the study. The records of the patients\' flow into the hospital for the
period of 1995 to 2005 were obtained from the Medical Records department. Furthermore,
the necessary records of services utilisation were also retrieved from the HRCC and EEG
units; and an audit evaluation was carried out on the obtained records. Observation of
services rendered in these units (HRCC and EEG) was also carried out by three recruited
research assistants.
In the first year of the EEG unit in the hospital, 560 patients had EEG recording
done in the centre; 44% of them were from outside the institution. The figure rose to 1326
patients in the fifth year, with 57.7% from outside the institution. Similarly, for HRCC, the
number of patients\' attendances in the clinic rose from 3033 in 2001 (91.7% hospital staff
attendances and 8.3% attendances from the community) to 5013 in 2005 (76.0% hospital
staff attendances and 24.0% from the community). For psychiatrically ill patients, the total
number seen in the facility rose from 23488 in 1995 (5 years before the reorganization of
the destigmatization programme and the establishment of general healthcare services) to
40513 in 2005 but with a peak of 41116 in the year 2003.
Although expediency (especially for EEG) may partly explain the citizenry\'s
patronisation of the services provided in the study centre; it is concluded that the subjects,
especially the non-psychiatrically ill ones would most probably disregard perceived
psychiatric stigma and not mind to utilise the general health services provided within the
premises of the psychiatric facility when the need arose.


Nigerian Journal of Psychiatry Vol. 5 (1) 2007: pp. 19-25