Readmissions to a psychiatric hospital. Outcome on follow-up

Readmissions to South African psychiatric hospitals form 45% of their intake and constitute a considerable burden on staff and facilities. The situation was investigated in a series of 460 patients sequentially admitted to a large, actively admitting hospital (Valkenberg Hospital, Cape Town). There was a difference in the proportion of readmissions within 1 year for different population groups--26,5% for white, 41% for coloured and 42% for black patients. The factors influencing this are explored. There was a marked difference in diagnoses--schizophrenics and affective disorders being more common in the black and coloured cohorts. Possible reasons for this are discussed. A 2-year post-discharge follow-up study showed a marked and sustained fall in the severity of psychiatric symptoms and difficult behaviour for all cohorts, but not of functional impairment, which was present in approximately 90% of all patients. Adequate aftercare and rehabilitation facilities in the community are evidently lacking.