The capacity of district hospitals to accommodate the decentralisation of mental health services: a cross sectional study of five government district hospitals in Botswana

Abstract

ABSTRACT Introduction In Southern Botswana, an expected advantage of the decentralisation and integration of mental health services into general health services was the potential to allow for the district hospitals to manage a larger number of mentally ill patients thus decreasing the patient load of Lobatse Mental Hospital. However, the number of admissions to the referral hospital for the south of Botswana is increasing. The objective of the study was to describe the capacity of district hospitals to care for mentally ill patients in terms of the provision of relevant inpatient, outpatient and outreach mental health services as well as the availability of trained workers who agree with the principles of decentralisation of mental health services. Materials and methods This was a descriptive cross sectional study involving a self-administered questionnaire survey of key informants and health care providers conducted in five district hospitals in the south of Botswana. There were a total of 5 Chief Medical Officers, and 75 ward staff (12 doctors and 63 nurses) in the study. The quantitative data was entered using the Statistical Package for Social Scientists (SPSS version 13) and analyzed by this software. The qualitative data was coded and thematically analysed and reported. Results In all five hospitals, all the doctors and nurses had undergraduate training in psychiatry and were expected to manage mentally ill patients. There were eighteen health workers (1 doctor and 17 nurses) with postgraduate training in psychiatry/mental health.