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Mortality rate in patients in a long-term psychiatric care facility in Johannesburg


Mokgokong Mathekga
Nokhutula Mdaka
Mvuyiso Talatala

Abstract

Background: Limited research exists on mortality rates and contributing factors among
individuals with severe mental illness (SMI) in long-term psychiatric care, especially in lowand middle-income countries (LMICs).
Aim: To analyse mortality rates and associated factors at Solomon Stix Morewa Memorial
Hospital (SSMMH), a long-term psychiatric care facility in Johannesburg, South Africa.
Setting: SSMMH, a private facility in Selby Park, Johannesburg, has been contracted by
the Gauteng Department of Health since March 2017 to provide inpatient care for SMI
patients.
Methods: A retrospective analysis was conducted on records of 406 SMI patients
admitted to SSMMH from March 2017 to February 2022. Mortality rates were calculated,
and associated factors were analysed using descriptive statistics and logistic regression.
Results: Of the 406 participants, 34 (8%) died over five years, yielding a standardised
mortality ratio (SMR) of 1.28 (95% CI: 0.85–1.71). Mortality was highest in the 60–69 years
age group (SMR 2.7), with most deaths occurring in 2020–2021, likely due to COVID-19.
Cardiovascular conditions were the leading cause of death (53%). Age at admission (OR: 2.35,
95% CI: 1.55–3.58) and transfer site (OR: 0.58, 95% CI: 0.42–0.81) were significant predictors
of mortality.
Conclusion: Individuals with SMI face elevated mortality rates, with age, diagnosis, and
comorbidities as key factors.
Contribution: This study provides insights into the comprehensive management of people
with SMI to reduce mortality. Further research is needed to guide psychosocial and palliative
care approaches.


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eISSN: 2078-6786
print ISSN: 1608-9685