Mental Health in Primary Care: An audit of psychiatric disorders seen at Kraaifontein Community Health Centre, Cape Town
ENGLISH ABSTRACT: Background: The purpose of this study was to identify the mental disorders treated by a primary care mental health service in a clinic in the Cape Town Metropole. There is very little data on primary care psychiatry in the Western Cape and this study has shed light on the prevalence of mental health conditions managed by mental health services at this level. Aims and Objectives: The aim of this study was to identify the conditions diagnosed in patients treated at Kraaifontein Community Health Centre’s Mental Health Clinic from 2010 to 2014. The specific objectives were to describe the demographics of the patient population at the clinic; to evaluate the type and frequency of psychiatric conditions treated; to evaluate the role of the nurse vs. the role of the doctor in these consultations; to evaluate the original source of referral to the clinic; to evaluate the presence of co-morbid medical disorders; to determine the treatment outcomes of these patients during this period and to look for trends in the above indicators over time. Method: This was a descriptive study, by means of a retrospective audit of the medical records of mental health care users, who attended the mental health clinic at Kraaifontein CHC from 2010 to 2014. A representative sample of the records was included in this study for this period and stratified random sampling was used to select 50 folders from within each year cohort. No exclusion criteria were used. Results: The mood disorders and psychosis were the most frequent diagnoses in this study, which differed from previous population based studies, where the anxiety disorders were more prevalent (together with mood and substance abuse disorders). Findings of this study has further highlighted the fact that apart from their psychiatric diagnosis, almost a third of mental health patients at this clinic had concomitant co- morbid disorders and unemployment was high. This study has revealed the need for further improvements at primary care level, for example, screening for early illness, substance abuse interventions and psycho-social rehabilitation. Conclusions: Primary Healthcare Psychiatry plays a significant role in the management of mentally ill patients and helps facilitate the access to other mental health services, including higher levels of care. A comprehensive mental health service, including social work support, is needed.