PATTERN OF PSYCHIATRIC INPATIENT ADMISSION IN IBADAN: IMPLICATIONS FOR SERVICE ORGANISATION AND PLANNING

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Olayinka Atilola¹ and Funmilayo Olayiwola²

1. Senior Registrar, Dept of Psychiatry, University College Hospital Ibadan, Nigeria.
2. Nursing Officer, Nursing Services Division, University College Hospital Ibadan, Nigeria.

Abstract

Introduction: Reports from different parts of the world has shown a seasonal pattern in psychiatric admission. Seasonal changes in climatic and social situations have been attributed. Such audit of psychiatric services is not a popular research venture in Nigeria.

Objectives: The study aims to describe the pattern of old psychiatric admissions in a tertiary health facility and the socio-cultural and environmental factors that may influence the pattern.

Methods: Data on monthly admissions over a 5-year period were extracted from the admission and discharge records kept by the nursing services unit. The data was processed using Microsoft excel and the pattern over the 5-year period was examined using graphical representations.

Results: There were 2140 admissions during the review period, comprising 1138 ( 53.2%) females and 1002 males. The mean new admission per month was 34.55 (M:16.7, F:18.96) with a standard deviation of 7.49 for all admissions. There was a seasonal pattern in admission. Some socio-cultural and environmental factors that may explain the pattern were examined.

Conclusion: This study suggests a seasonal pattern of psychiatric admission in a tertiary health facility in Ibadan. Recommendations were made on how to make use of the knowledge of the seasonal pattern of admission to mitigate disruptions in workload that may be occasioned by the observed pattern.

Keywords: Admission, Pattern, Psychiatric, Seasons, Nigeria

Introduction

Inpatient care of the mentally ill, though expensive and resource intensive, is still the safest and most effective mode of treatment for patients adjudged unmanageable at home or in the community¹. Seasonality in utilisation of psychiatric facilities has been observed as far back as the 70s² and this observation has not changed till date as recent studies have found monthly variations in psychiatric admissions with a peak around summer or at the peak of local temperature^3,4. Such audits of psychiatric services including hospital service indices like hospital utilisation index or bed occupancy rates are not a popular research venture in Nigeria. It is possible that there are other place-specific contextual variables that may explain any seasonal pattern of psychiatric admission that may be found in Nigeria. Such findings may improve the preparedness of mental health facilities by guiding service organisation and planning in most sub-Sahara African countries like Nigeria where mental health services are poorly developed and professionals are scarce⁵.

OBJECTIVES
The study is descriptive in nature and aims to describe the monthly pattern of admissions in the psychiatric ward of a teaching hospital in Nigeria and to examine cultural, environmental and other factors that may influence the pattern.

MATERIALS AND METHODS
Setting
The study was conducted at the psychiatry department of University College Hospital, Ibadan, Nigeria between the months of February and March 2009. The psychiatry ward is a 64-bed facility divided into a male and a female wing. The facility principally serves Ibadan and its environs, with a population of close to 5 million; its catchment area, however, is not well defined. The Nursing service unit keeps a monthly admission and discharge register of all patients admitted into the wards. This record contains the sociodemographic data and outcome of all patients.

Procedure
Data on monthly admissions over a 5-year period for the two wards, spanning from April 2004 to March 2009, were extracted from the admission and discharge records kept by the nursing services unit. The data was processed using Microsoft excel and the pattern over the 5-year period was examined using graphical representations.