Pattern of Defaulting from a Nigerian Child and Adolescent Psychiatric Clinic.

Pattern of Defaulting from a Nigerian Child and Adolescent Psychiatric Clinic.

Author by Dr. Increase Adeosun

Journal/Publisher: Nigerian Journal Of Psychiatry

Volume/Edition: 10

Language: English

Pages: 13 - 17

Abstract

Background: Despite the availability of effective treatment for childhood psychiatric disorders, the successful treatment of children and adolescents who access mental health services is undermined by high rates of default from these services. There is paucity of data on the pattern of default from child and adolescent psychiatric services in Nigeria. Such data is vital for health service planning and may inform interventions that may improve service utilisation.

Aim: To determine the pattern of default from the Child and Adolescent (C&A) clinic of the Federal Neuro-Psychiatric Hospital, Yaba.

Method:  This study was retrospective in design. Using a pro forma, case notes of all patients registered at the C&A Clinic of the Federal Neuro-Psychiatric Hospital Yaba, within a period of one year, were reviewed to determine their pattern of default from clinic appointments.  

Results: Out of the 450 patients who commenced treatment within the period of review, the case notes of 404 patients (89.8%), with comprehensive data, were available. They were predominantly males (57.7%) with an age range of 6months to 17years (mean age= 9.3 ± 4.9yrs). A fifth of the sample missed their first clinic appointment. By the 2nd appointment, the percentage of defaulters had increased to 51.0%. The median duration of retention in treatment before defaulting was one month. Six out of 10 children had dropped out of treatment for more than one year. Patients who missed their first appointment were more likely to drop-out from treatment (p<0 p=0.03) p=0.02)>

Conclusion: There is a high rate of default from C&A psychiatric services in this environment. In addition to the need to mount universal interventions to abate default from child mental health services, efforts geared towards improving retention of children in treatment may need to target children who are unaccompanied by both parents at their index visit to the clinic and those who miss their first appointments.


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