Substance Use in Patients Presenting with Mental Illness at Chris Hani Baragwanath Academic Hospital Emergency Psychiatric Unit – A Descriptive Study

Abstract

Background: Substance use is known to be increased among psychiatric patients. It impacts the clinical and social outcomes of patients. Substance use is also a contributing factor to psychiatric admissions and presentations to emergency units. Aims: To describe the substance use pattern and demographic profile of patients presenting to Chris Hani Baragwanath Academic Hospital (CHBAH) psychiatric emergency unit. Setting: The study was conducted in the psychiatry emergency department at CHBAH, a tertiary hospital in Johannesburg, South Africa. Methods: The study is a cross-sectional descriptive study. Data regarding substance use and demographic profile of the patients was collected using a structured data sheet. Statistical analysis was conducted to compare the substance use and non- substance use groups. Results: Data was collected from all adult patients presenting to the CHBAH emergency psychiatry department over the 3-month period of 1 October 2019 to 31 December 2019. Data was collected from 210 patients of which males represented the majority (84%). 154 (73%) patients had a history of substance use. Cannabis was the most used (66%) substance. Patients in both groups were mostly unemployed and there was no significant difference in the employment rate between the two groups. Non-adherence was significantly greater in non-substance users. Violence was the leading presenting complaint in both groups however a significantly greater proportion of substance use patients were admitted because of violence. Conclusion: Substance use is highly prevalent in this study population. It is likely a contributing factor to presentation to a psychiatric emergency unit. Preventative measures and specialised treatment for dual diagnosis is important to ease the burden on psychiatric services and to produce better outcomes