The appropriateness of certification of patients to Sterkfontein hospital .

Faculty of Health Sciences School of Medicine 0110993v Tel: 011 984 1268Section 9 and 12 of the South African Mental Health Act No. 18 of 1973 as amended, defines standards and procedures related to the involuntary commitment of mentally ill persons to mental institutions or care and rehabilitation centres. Despite these provisions in practice clinicians are faced with the challenge of appropriateness of certification of mentally ill persons to psychiatric hospitals. This study was undertaken to establish the number of patients regarded as inappropriately certified and admitted to Sterkfontein Psychiatric Hospital over one month during 2003. The clinical and demographic characteristics of this group were investigated. Its impact on hospital resources was assessed and commitment standards were compared. The patients’ hospital records were used to achieve the above objectives. About 20% of patients were found to be inappropriately certified as per definition, collectively they spent a total of 834 days in hospital at the cost of over half a million rands. It was concluded that in practice there may be patients who are inappropriately certified and that they significantly impact on hospital resources. Reasons for this need further investigations and the certification standards and procedure may need to be revised to minimize the problem