Abstract:
OBJECTIVE: The slow discharge of long-term psychiatry patients from Weskoppies Hospital into the community has not matched
the national and international drive towards deinstitutionalisation. This article investigates patient and social work factors related
to successful community placement, in the context of limited community care facilities. METHOD: Thirty-six long-term patients
who were successfully placed outside of the hospital during a seven month period were compared to 235 unplaced long-term
patients in terms of demographic and clinical variables. Social work services were analysed in terms of which patients received
the most interventions, and the most common type of interventions. RESULTS: The most significant patient factors associated with
successful placement were: female patients; medium-to-high level of functioning; having involved relatives living far away; a low
frequency of behavioural problems (especially of cannabis abuse, verbal or physical aggression, uncontrolled sexual activity), and
agitation or restlessness. These patient factors were mirrored in the social work services rendered to the long-term patients during
the study period: The recipients were mostly female, in open wards (higher-functioning); and the social services utilised were
mostly related to planning for placement and patient support. CONCLUSION: The lack of community care facilities in the Pretoria
area that are able to care for the more difficult long-term psychiatry patients, limits successful placement and increases the burden
of hospital based social workers. The problem cannot be resolved at a hospital level and needs to be addressed in the context of
provincial and national health departments.
