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Mental Health Series

Admission in mental health care institutions

The MidweekSun Admin

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Most of our avid readers often enquire about the procedure for admission at mental health institutions. The admission process and the general provision of mental health services is guided by the Botswana Mental Disorders Act of 1971(currently undergoing review) and the Criminal Procedure Act Chapter 08 for forensic situations.

There are basically two categories for admission in a mental health facility which are voluntary and involuntary. We will focus on the involuntary admission for this discussion. Involuntary admission is two pronged, being an urgency order and a reception order. In an urgency order, a relative or a Police Officer of the rank of Seargent and above can make an application for an individual who is deemed to be a danger to self or others to be admitted on account of mental illness, as ratified by a medical certificate.

Under this order an individual is admitted for a period not exceeding 14 days and can be extended or stopped by a District Commissioner (DC) upon getting a report on the patient. As the name implies, urgency order is done on the basis of emergency.

Getting to a reception order, the process is different. A relative or someone over 21 years who has been with an individual who seem mentally unwell for over 48 hours, makes an application to the DC’s office. The patient/client then is assessed by a medical officer who will produce a medical certificate with observations and indicating whether the patient needs to be managed in an institution. The DC will then use the guardian/relative/parent application to make a determination as to whether the individual can be given a reception order to facilitate an admission. The reception orders is valid for a period of 30 days and may be extended when patient has not adequately improved.

Involuntary admission is only used in instances when a patient has no insight and ability to make decisions. In a situation whereby patient is able to consent and voluntarily agrees for admission let it be so. Whilst it is vital that patients be admitted when necessary, efforts should be made to deinstitutionalise mental health services with some cared for at home.

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Mental Health Series

LET’S PRIORITISE MENTAL HEALTH IN 2019

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It’s a new year, the buzzing word is “goledzwa” or “ngwaga o mosha”. This period has a bearing on people’s mental health in various ways. Some are gearing up for the year ahead whilst others are stuck in the disappointments of the previous years. The two situations inter alia poses direct consequences for mental health.

Those bracing gigantically for the New Year often set themselves for certain accomplishments. Setting resolutions is a welcome phenomenon but the crux of the matter is that they should be realistic and attainable. The problem comes about when we are unable to meet such expectations as we may start self-loathing about the failures. This often is a precursor to development of most mental health problems especially when the failure is not addressed effectively. As summed up by Andrew Carnegie, “if you want to be happy, set a goal that commands your thoughts, liberates your energy and inspires your hopes.”

It is quite critical for us not to wallow in the disappointments of the previous year as we surge into 2019. Disappointments harbours sadness, anger, anxiety and resentment which are cardinal features of most mental health problems. Depression and suicides are problems that most often than not are linked to failure to deal effectively with disappointments and failures. A good lesson can be of Nelson Mandela’s life in relation to prison sentence. Mandla Langa wrote about Mandela that; “prison, a place of punishment, instead became a place where he was able to find himself.

A place where he could think, indulging in the one thing that gave him a sense of self.” Mandela displayed immense fortitude; we can all borrow a leaf and make the best out of our circumstances and effectively deal with adversity.

Let us convey optimism in all aspects of life. We can continue with exercise, good adequate nutrition, self-love and financial management as those are some of the basic foundations for positive mental health. There is no health without mental health thus I implore everyone to prioritise mental health in 2019!

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Mental Health Series

THE MENTAL HEALTH SERIES

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It’s the holiday season all over again. It’s all glitz and glamour but not for those diagnosed with mental and addiction disorders in that at this point in time they may likely get relapses.

A relapse is a state whereby individuals experience a setback of reoccurrence of symptoms after they have been well managed for some time. Individuals diagnosed with mental illness must not feel bad about relapsing as it happens with many of the chronic illnesses. People diagnosed with diabetes, hypertension and asthma consistently relapse but there is never a point wherein they are castigated for that!

The relapses are often facilitated by the following;
Non-compliance to treatment
Hiding the diagnosis from family members because of their over judgemental and denialism attitude
Non-acceptance by family members
Family members wanting to go for holiday and rooting for unjustified admissions for patients
Stigmatising tendencies from care givers and community members
Stress related to finances

In order to avoid relapses a lot should be done and all should play a role. Early signs of an impending relapse should be addressed promptly by going to a mental health professional for assessment and management. It is essential that treatment be taken as ordered at all times and individuals should ensure they have enough supply for the holiday period. Family members should play an active supportive role to avoid relapses and be cognisant of the fact that relapses are not “self-inflicted” and can occur even when taking treatment properly.

It is important for those diagnosed with addiction disorders to be wary of association especially with those they used drugs with, lest they hoodwink them into using substances again. It also important to avoid places where drugs are easily available as that could be tempting. Lastly those recovering from addiction disorders should know their “triggers” and how to deal with cravings especially since during the holiday season plenty of substances are “readily” available.

“The Mental Health Series” wishes all the readers a mentally healthy and a prosperous holiday period! Thank you for the interaction and support.

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