Factors Influencing Relapse Among Mentally ill Patients in Butabika National Mental Hospital.

Abstract

Introduction: Mental illnesses pose one of the greatest burdens within the medical fraternity in the world (Lane and Kim, 2009). According to the World Health Organization (WHO), around 450 million people suffer from conditions such as placing mental disorders, which is among the leading causes of ill health and disability worldwide (WHO, 2001). However, the relapse among mentally ill people is high as nearly two-thirds of people once treated do register only a short-term improvement (WHO, 2001) which have been blamed on the stigma, discrimination and neglect (WHO, 2001). Methodology: The study was carried out at Butabika National Referral Hospital. Butabika lies in the southeastern part of the city, in Nakawa Division, adjacent to the northern shores of Lake Victoria, Africa's largest fresh-water lake. This location is approximately 12 kilometres (7.5 mi), by road, east of Kampala's central business district (Mukisa, 2013). Butabika Hospital is a public psychiatric hospital, funded and administered by the Uganda Ministry of Health and general care in the hospital is free. The hospital is the only referral psychiatric hospital in Uganda. The hospital also serves as the psychiatric teaching hospital for Makerere University College of Health Sciences for both undergraduate and postgraduate training, especially for the degrees of Bachelor of Medicine and Bachelor of Surgery (MBChB), Master of Medicine in Psychiatry (MMed Psych) and Doctor of Philosophy (PhD) in Psychiatry (Lydia Lakwonyero, and Simon Longoli, 2009). The study population was the caretakers of mentally ill patients. Results: The findings were arrived through analysis and interpreting of the data that was collected from the field and existing scholarly works. The data collected was subjected to software package for social research such as SPSS version 16. All the responses were presented in terms of frequencies and percentages which were displayed in tables, charts and graphs. Out of the 130 questionnaires distributed to the targeted sample, 122 responses were received, and these constitute the realized sample. The total response rate was 94%. Additionally, group discussion was conducted with randomly selected respondents. Recommendations: There is need for health policy makers to improve mental health and reduce the burden of relapse among mentally ill patients, their families and community as a whole. In addition, the results can help establish clear policies articulating measures to reduce relapse among mentally ill patients and then develop systematic plans with dedicated budget and agreed timelines. Management of mentally ill patients can be improved by addressing the factors influencing relapse as highlighted in this study. The findings call for improvement in mental health care service delivery to mentally ill patients. It is important that in the local context, mental health nurses strengthen their therapeutic relationships with caretakers. This enables caretakers to express their needs and concerns to the nurse, and the nurse to plan proper interventions in caring for the patient; meanwhile working with other mental health professionals as a team. Heath workers at the facility should extent outreaches to all discharged patients for psycho education. Especially on drug instructions, side effects that might arise after discharge from health facility.