Understanding the revolving door mental patients`phenomenon in Kabale Hospital, Uganda

Abstract

The revolving door mental patients` phenomenon is closely linked with the nature of seeking psychiatric treatment among mental patients. This is also associated with the inadequacy of the practices of caring for people with enduring mental illness away from hospital. This study aimed at understanding the revolving door mental patients` phenomenon in Kabale Hospital and was guided by three specific objectives which are aimed at understanding the manifestation, attributed factors and consequences on the mental patients and the caretakers. As regards the existing literature, there is a resource gap in provision of psychiatric services due to high frequency users. These patients use between 50 and 80% of service resources and have high levels of need. Therefore, effective management of revolving door mental patients would free up resources for other users of psychiatric services. There is also limited information on the revolving door mental patients` phenomenon in Uganda Therefore, the study is intended to deepen the understanding of the revolving door mental patients` phenomenon in order to improve the management of revolving door patients and the distribution of psychiatric resources. Methodologically, the study employed a qualitative approach of data collection using an interview guide for primary participants and a key informant guide. The study participants were revolving door mental patients and their care takers who were selected purposively on basis of the researcher`s judgment on who can provide information to enable the realization of study objectives. The study had 9 primary participants who provided information based on experiences and 3 secondary participants that provided information based on expertise. The study findings revealed that the revolving door mental patients` phenomenon had a high prevalence and the revolving door mental patients were admitted both voluntarily and involuntarily after relapse. In addition, participants reported different attributes for example Lack of social support and stigma. On one hand was public stigma and on the other hand self-stigma. Participants went ahead and identified the consequences with financial burden being a point of common discussion. The study concludes with recommendations to social workers, policy makers and service providers and to researchers to bridge the information gap and ease service delivery to all mental health service users.