Can community volunteers work to trace patients defaulting from scheduled psychiatric clinic appointments?

摘要

To the Editor: Mental illness is set to become the second largest source of economic and social burden worldwide by 2020. In many South African township communities, effective treatment is hampered because stretched professional staff are unable to follow up defaulting patients. Defaulting can have disastrous consequences for patient health, including treatment breakdown, imprisonment, death by suicide, harm to others, homelessness, relapse and re-hospitalisation. Many countries have employed 'assertive outreach' workers to address the negative consequences of defaulting. These workers enable patients to remain in contact with services, resulting in enhanced treatment compliance, improved employment status and greater patient satisfaction. In South Africa important public policy principles such as community involvement and the role played by volunteers in supporting family members and helping patients remain in treatment must be incorporated into mental health assertive outreach systems, just as they have in key programmes such as directly observed treatment for tuberculosis and HIV/AIDS voluntary counselling and testing.