Description of the inpatient population and care received at a psychiatric unit in Lilongwe, Malawi

ABSTRACT

Like in much of sub-Saharan Africa, descriptive data about psychiatric inpatients and inpatient psychiatric care in Malawi is limited. This study describes the inpatient population at the Bwaila Hospital Psychiatric Unit in Lilongwe, Malawi, as well as treatments received and treatment outcomes. Records of 419 psychiatric inpatients hospitalized from January 1, 2011, to December 31, 2011, were reviewed. Patients were primarily male (73.0%) and were most commonly referred from district hospitals (46.4%). Nearly all patients were involuntarily hospitalized under Malawi's Mental Treatment Act (94.2%). Schizophrenia (30.1%), cannabis use disorder (27.9%) and alcohol use disorder (25.1%) were the most common diagnoses. Suicidal ideation was reported by 4.8% of patients and 2.4% had attempted suicide prior to admission. Homicidal ideation was reported by 7.3% of patients and 5.1% of patients assaulted another patient during their hospitalization. Mean length of stay was 22.1 ± 27.7 days (range: 1.0–243.0). Chlorpromazine (81.3%), diazepam (75.8%), carbamazepine (59.8%) and fluphenazine (56.0%) were the most commonly used medications on the ward. Stabilization and discharge to home was the most common outcome (68.0%), followed by transfer to another hospital (19.5%), discharge against medical advice (8.2%), abscondment (3.4%) and death (1.0%).

KEYWORDS:

• Africa south of the Sahara
• Malawi
• mental disorders
• mental health
• psychiatry

Acknowledgements

We thank the administration, patients and staff of the BH Psychiatric Unit who enabled us to carry out this investigation. We would also like to thank Laura Ball and Travis Tressler for their assistance with data entry.

Disclosure statement

No potential conflict of interest was reported by the authors.

ORCID

Brian S. Barnett http://orcid.org/0000-0002-8963-5701

Additional information

Funding

The work was supported by funding from the University of North Carolina Center for AIDS Research, a National Institutes of Health (NIH) funded program [grant number P30 AI50410 (http://unccfar.org/acknowledge-the-cfar/)]; the NIH Fogarty International Clinical Research Scholars and Fellows Program at Vanderbilt University [grant number R24 TW007988 (http://grantome.com/grant/NIH/R24-TW007988-05)]; and a National Institute of Mental Health career development award [grant number K01MH100428 (https://taggs.hhs.gov/Detail/AwardDetail?arg_AwardNum=K01MH100428&arg_ProgOfficeCode=134)].