Mental Health Public Health and Health Systems

Bara psych unit ‘€˜swamped’€™

Written by Khopotso Bodibe

A growing number of people with mental illnesses are placing a strain on Chris Hani Baragwanath Hospital, in Soweto, as there are fewer staff and facilities to serve them.

98ff60e22412.jpgChris Hani Baragwanath Hospital is the only government hospital in Soweto serving some 1.3 million people. With no district or regional hospitals providing mental health care in the hospital’€™s catchment area, Chris Hani Bara is the first port of call for patients with psychiatric illnesses. The hospital’€™s psychiatric unit has six wards and 165 beds for psychiatric patients ‘€“ men, women and children. Professor Yasmien Jeena, head of the hospital’€™s Department of Psychiatry, describes the service as ‘€œan acute unit that is very large for a tertiary academic hospital’€.

‘€œThat is because of the population we serve. Patients are referred from primary health care, from the private GPs in the area and we also see patients from far as wide as Lesotho, Swaziland, north of our borders. The reason we have so many beds is because the need is there. I’€™d like to emphasise that we are an acute facility. We’€™re not a chronic facility. The patients that we admit are actually quite sick’€, Professor Jeena says.

Often, the unit struggles to admit new patients because of the dire need.  

‘€œWe only take really, really sick people and, often, we send home really sick people because we don’€™t have a bed available for them. Then once the patient is admitted to our ward, they are stabilised. But because we have pressure for beds and we have pressure to keep our length of stay short because we are an acute unit, we discharge patients when they start to get well. We don’€™t have the luxury of keeping them in hospital to consolidate that recovery process and so, we discharge patients quickly’€, says Dr Wendy Friedlander, a psychiatrist in the hospital’€™s adult psychiatry unit.

However, as has become the norm in the public health sector, the staff complement does not reflect the reality of the patient turn-over.

‘€œWe are swamped. Our staffing is way below what would be expected for the number of patients that we deal with. So, we are swamped. We see an average of about 15 new patients presenting for admission a day and, by any standard, that is very high for any psychiatric facility’€, says head of unit, Professor  Jeena.

‘€œIn-patients for children under the age of 12 are accommodated in ward 80, which is a 10-bedded in-patient unit where we can keep up to a maximum of seven patients because of nursing restrictions’€, adds child psychiatrist, Dr Wendy Duncan.

Besides the in-patients, the unit has out-patients to look after. Recent statistics show that for the month of May alone, 930 adult out-patients were seen, while child patients amounted to 571. All these were seen by eight psychiatrists who move between four sub-units. In comparison to the rest of the country, the burden of mental disease at Chris Hani Baragwanath Hospital could be the tip of the iceberg. Research shows that about 16.5% of South Africans will suffer from a mental disorder in their lifetimes.

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Khopotso Bodibe

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