Dedicated Adolescent Psychiatry Unit Opened at Tygerberg Hospital

Tygerberg Hospital’s new psychiatry unit caters for the unique needs of adolescent patients.

For decades these young patients have had to share ward space with mentally ill adults, a situation which nothing but outstanding nursing care prevented from becoming an unacceptable risk. Young psychiatric patients require different nursing care from adult patients. Activities and ward routines have to be developmentally appropriate and the minimal effective constraint is used. After many years of planning, these patients and their treatment team at last have their own space. There is an outside space for soccer and basketball, as well as inside day rooms for relaxation and recreation.

Tygerberg Hospital’s Adolescent Psychiatry Unit is the Western Cape’s only tertiary assessment unit for adolescents with psychiatric disorders. The young patients admitted to this unit are referred by regional, district or private sector psychiatry services. They for the most part are suffering from major psychiatric disorders such as schizophrenia or bipolar disorder. Some are admitted because they are at acute risk for self-harm or harm to others. Some have psychiatric symptoms which turn out to be due to general medical illnesses. A small but very experienced child and adolescent psychiatry team provides specialised diagnostic assessment and initial stabilisation before transferring suitable patients to the psychosis recovery unit at Lentegeur Hospital.

Dr Hawkridge, Clinical Head: Child and Adolescent Psychiatry Unit, said: "The accurate assessment and specialised management of adolescents with neuropsychiatric disorders is crucial in obtaining optimal outcomes. Having an adolescent psychiatry unit within a central academic hospital provides the best possible environment for achieving this goal. It is important that adolescents with psychiatric disorders have their own inpatient space, as they require nursing care that is specifically tailored to their needs and abilities. A dedicated adolescent psychiatry assessment unit allows us to build up expertise and experience in this critically under resourced field. This is a huge step forward for adolescent psychiatry in the Western Cape."

The ward is divided in two sections, with five beds in a less restrictive environment for patients whose behaviour is not severely disturbed. Eleven beds are in a more secure environment for patients who are still very ill. A state-of-the-art security system ensures 24/7 observation and a dedicated team of nursing staff is rapidly becoming expert in behavioural management. The inpatient unit team is led by a child and adolescent psychiatrist and comprises a senior clinical psychologist, nurse therapist, professional nurse, clinical social worker, and an occupational therapist. Support staff, security and housekeeping complete the team, all of whom have to be able to interact appropriately with mentally ill teenagers.

As in many areas of mental health care all over the world, demand far outstrips available bed space and the waiting list for admission to our unit is an ongoing challenge. We are fortunate that many of our district hospitals have enthusiastically and competently joined the care team and are, in collaboration with our team, managing many young patients with psychiatric disorders in their hospitals, either until a bed is available in our unit, or until the patient is recovered sufficiently to be discharged.