The care, treatment, rehabilitation and legal outcomes of referrals to a tertiary psychiatric hospital according to the Mental Health Care Act No. 17 of 2002

Abstract

BACKGROUND : The Mental Health Care Act No. 17 of 2002 (MHCA) was introduced to combat poor care received by mentally ill persons. OBJECTIVE : The objective of this study was to evaluate diagnostic and treatment accuracy as well as compliance with procedural matters related to the MHCA, using a sample in the northern region of Gauteng Province, South Africa. METHOD : Files of 200 patients admitted to Weskoppies Hospital between June and December 2009 were evaluated for admission procedures, and care, treatment and rehabilitation (CTR). RESULTS : From referring hospitals, 174 (87%) persons had appropriate signs and symptoms documented in the referral note or MHCA forms. All of these were appropriately diagnosed. Although about one-third of the patients’ treatment was not documented, more than 50% (n=163) received the correct treatment. In two-thirds of patients, correction of detected abnormalities was not documented. Approximately 50% of the admissions had documents that did not adhere to MHCA provisions. At Weskoppies Hospital, CTR was considered appropriate for 92% of the patients. The legal status of the majority of patients was involuntary at discharge point. The majority of persons stayed for <3 months but for longer than what medical aid schemes allow in the private sector. CONCLUSIONS : The study highlighted both improvements and gaps in CTR given to mentally ill persons in the northern Gauteng region, which might apply to the rest of the country. Medicolegal requirements stipulated by the MHCA are still a challenge a decade post enactment, but there may be a move in the right direction.