Volume 56 Issue 1- March 2020 : Feature

Inside Sbrana Psychiatric Hospital

Author : Baleseng Batlotleng

Just a few days after the world celebrated yet another milestone in providing rehabilitative mental health care to its citizens during the World Mental Health Care Day, Kutlwano staffer travelled to the old town of Lobatse and took a tour of Sbrana Psychiatric Hospital.

Just 72 kilometres to the south east of the capital city Gaborone, the hospital sits on a 12.5 hectare plot, a total floor area exceeding 40 000 square metres and a squeaky clean 300 bed capacity, making the hospital one of the most modern psychiatrist facilities in the continent.

The hospital was named after the late Italian psychiatrist specialist, Dr Giuseppe Sbrana, who was the first specialist to work at the then Lobatse Mental Hospital in 1969. The naming of the hospital is in recognition and appreciation of the contribution and legacy of the late Dr Sbrana to the development of mental health in Botswana. 

The multimillion Pula state-of-the-art facility has opened a new chapter in the state of mental health care in Botswana. It is also the only national referral hospital for psychiatrist conditions in the country.

The hospital`s public relations officer, Same Gower, took Kutlwano team on a two-hour guided tour of the facility.
Reception

Probably the first stop for all visitors and the place where files are opened for patients and records are kept for incoming clients. A medical record clerk in charge takes care of all the logistics.

Psychology Social Outpatient Department
This is the next stop from the reception. Here a chief registered nurse is in charge. The administration of vital signs checkup, blood pressure temperature and weight are done here.The patient, depending on their condition, is then taken for an interview by a general nurse before being referred to a sanity clinic, a special clinic for psychiatrists where visiting specialist consult patients. There is also an out-patient clinic where dietetics are done and the final assessment here is done by a doctor who can decide whether the patient is admitted or attended to as an out-patient. Part of the department includes the Central Sterilization Unit where sterilization packs are prepared through the use of an Autoclave machine. There is also the psychology unit where psycho-therapy and no medication is administered. Here it is strictly clinical psychology work.

Pharmacy
Serving as the patient dispensary unit. Other illnesses are catered for here nevertheless the focus is only on psychotropic drugs. The pharmacy also dispenses drugs for acute illnesses on a weekly basis while long term conditions are provided for on a monthly basis or depending on the doctor`s prescription. There is a cold room for temperature sensitive drugs and also a high security area for habit forming drugs which are only administered under strict regulations and strictly for therapeutic purposes only.

Female and Male observation Wards
A reception area for acutely ill patients. The ward is made up of the female and the male ward with the right wing ward being the psychogeriatric ward for elderly citizens. The only difference with the latter is age besides that the conditions of patients remain the same.

Forensic Rehabilitation Ward
The area is specially designed for mentally unstable offenders. This is a high care ward where nurses work closely with law enforcement officers to discharge respective duties. A psychiatrist assessment and evaluation of offenders who suffer from or are believed to suffer from mental illness is carried out here. This helps courts of law to decide on issue of the offender`s criminal responsibility and the best place to be accommodated after trial.

Rehabilitation Ward
For patients, this is the last stage of their stay in the facility. Here, mentally stable patients who require little or no supervision at all are housed. In this ward not all patients are psychotic. Some require suppression of withdrawal symptoms as a result of substance abuse. Where such efforts fail the patient is then taken to respective wards where there is seclusion. The ward also has occupational therapy where the patient is assessed and malfunctions are identified. Community behavioural therapy is administered as a way of reducing a patients` dependence on other people for daily routines. Art and craft, gardening and welding amongst others are provided. Skills are acquired here can also better their livelihoods when they are discharged from the hospital.

The Main psychiatric disorders affecting adults
 - Schizophrenia and related psychotic disorders
 - Mood disorders including depression, mania and bipolar mood disorder
 - Anxiety disorders, stress related disorders and adjustment disorder
 - Substance abuse disorders
 - dementia

What causes mental illness?
Mental illness is caused by a combination of different aspects namely genetic makeup or genetic predisposition of an individual combined with environmental factors such as
 - drug and alcohol abuse
 - family problems
 - stress
 - a difficult upbringing example social deprivation, physical and sexual abuse amongst others

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