THE OUTPATIENT CARE OF PSYCHIATRIC-PATIENTS IN A RURAL AREA - MHALA DISTRICT, NORTHERN TRANSVAAL

This study reviews the quality of outpatient care provided by the psyc hiatric service in the Mhala district of Northern Transvaal. A retrosp ective survey of 488 patient cards was undertaken at the end of 1989. Diagnoses showed a high proportion of epileptic (48%) and schizophreni c (22%) disorders, but few mood disorders (4%) and no anxiety disorder s. A number of drug combinations and usages for the recorded diagnoses were regarded as inappropriate. Between 42% and 46% of patients left the service in their first year of treatment. Attendance of patients w as inadequate and irregular. The referral rate to the district hospita l was low even in patients who suffered numerous relapses. These resul ts show a psychiatric service that requires improvement in many critic al areas. This can be achieved through decentralisation of the service while ongoing support is provided. This includes training, expert sup port in reviewing diagnoses and drug use, logistical support and a wel l-functioning referral system.