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The outpatient care of psychiatric patients in a rural area: Mhala district, Northern Transvaal
Abstract
This study reviews the quality of outpatient care provided by the psychiatric service in the Mhala district of Northern Transvaal. A retrospective survey of 488 patient cards was undertaken at the end of 1989. Diagnoses showed a high proportion of epileptic (48%) and schizophrenic (22%) disorders, but few mood disorders (4%) and no anxiety disorders. A number of drug combinations and usages for the recorded diagnoses were regarded as inappropriate. Between 42% and 46% of patients left the service in their first year of treatment. Attendance of patients was inadequate and irregular. The referral rate to the district hospital was low, even in patients who suffered numerous relapses. These results show a psychiatric service that requires improvement in many critical areas. This can be achieved through decentralisation of the service while ongoing support is provided. This includes training, expert support in reviewing diagnoses and drug use, logistical support and a well-functioning referral system.
Afr Med J 1995; 85: 571-577
Afr Med J 1995; 85: 571-577