DEPARTMENT OF PSYCHIATRY AND MENTAL HEALTH UNIVERSITY OF CAPE TOWN DEPARTMENTAL REPORT 2004 – 2014 WELCOME TO THE REPORT W ElcOME TO THE DEPARTMENTAL REPORT OF THE DEPARTMENT OF PSYCHIATRY AND MENTAL HEALTH AT THE UNIVERSITY OF CAPE TOWN. THE REPORT REPRESENTS THE SELf-reVIEW PORTFOLIO OF THE DEPARTMENT IN PREPARATION FOR OUR 10-year REVIEW COVERING THE PERIOD 2004-2014. The Report is presented in four parts. PART I introduces the Department and its achievements over the last 10 years, states the Terms of References generated in consultation with staff in the Department and in the Faculty of Health Sciences, and outlines the key findings of our self-review. In PART II, we present our Hospitals and Divisions to illustrate the breadth, depth and diversity of activities and sites for our work. PART III represents a summary of our strengths, weaknesses, opportunities and perceived threats across the five key themes of GOVERNANCE & ADMINISTRATION, RESEARCH, TEACHING & LEARNING, TRANSFORMATION and SOCIAL RESPONSIVENESS. In PART IV, Prof Dan Stein, our Head of Department, brings together a general reflection of the last 10 years, and proposes some thoughts for the future. I am extremely grateful to all members of the Department who participated in the process of self-reflection and self-review. It was a pleasure and privilege for me to explore all the corners of our Department and to experience the passion and enthusiasm everyone has for their work. We sincerely hope that this report will be not only a summary of the Department of Psychiatry and Mental Health as it is in 2015, but that it will also act as a reminder of all the things we still want to and can achieve in the next decade. Prof Petrus J de Vries Sue Struengmann Professor of Child & Adolescent Psychiatry DEPARTMENT OF PSYCHIATRY AND MENTAL HEALTH | DEPARTMENTAL REPORT 2004 – 2014 1 FOREWORD FROM THE INTERIM DEAN IT IS INDEED A GREAT PLEASURE FOR ME TO WRITE A FOREWORD TO THIS REPORT FROM THE DEPARTMENT OF PSYCHIATRY AND MENTAL HEALTH HIGHLIGHTING THEIR WORK OVER THE LAST DECADE. Mental health is an essential component of health work together to find solutions for what is one of the and is a basic human right, yet it is often not given major public health problems facing us. The research the attention that it deserves as a health and output and the educational programmes developed development issue. Mental disorders significantly in the Department are not only outstanding but also account for about 15% of the global burden of highly relevant to our needs. The challenge for us disease, defined as premature death combined over the next few years is to determine whether this with years lived with disability. If only the disability has had an impact on the health of people not only component of the burden of disease calculation is locally but also globally. taken into account then mental disorders account for about 30% of all years lived with a disability in low- We congratulate the Department on a job well done and middle-income countries. It is therefore a major and thank all the staff for their sterling work over concern for us that one third of all South Africans the years. Without their individual and collective suffer from a mental illness and it has been estimated commitment and dedication the Department of that 75% of them will not get any kind of help. Psychiatry and Mental Health would not be one of the premier academic departments on the African It is thus extremely gratifying to see that our continent. Department of Psychiatry and Mental Health has made significant strides in the field of mental There is no health without mental health! health over the last ten years. New transformative Professor Gregory initiatives, at a clinical, basic science, public health Hussey and community level, based on the needs of our Interim Dean, country, have been developed and numerous Faculty of Health Sciences collaborations, both locally and internationally, have University of Cape Town been established. In addition, good relationships have evolved with the Department of Health, the Department of Social Development, and with Non- Governmental Organizations in the Province, to FOREWORD FROM THE HEAD OF DEPARTMENT IT HAS BEEN A TREMENDOUS PRIVILEGE TO LEAD THE DEPARTMENT OF PSYCHIATRY AND MENTAL HEALTH AT THE UNIVERSITY OF CAPE TOWN AND ITS AFFILIATED HOSPITALS FOR THE PAST 10 YEARS, WHICH COINCIDES WITH THE TIME PERIOD OF THE CURRENT UNIVERSITY REVIEW. This review speaks to the tremendous skills and My warm thanks to all of those who participated energy of our staff and students and demonstrates in this review, to our staff and students who do us that we are one of the leading Departments proud, and to the many, many partners we have of Psychiatry in the low-middle income world locally, in Africa, and – providing relevant teaching, cutting-edge internationally, who help research, innovative services and robust and support us. advocacy for our patients, in an integrative and transformative way, and in keeping with a primary Prof Dan Stein care approach. It also speaks to many areas for Head of Department future possible improvement. 2 DEPARTMENT OF PSYCHIATRY AND MENTAL HEALTH | DEPARTMENTAL REPORT 2004 – 2014 CONTENTS WEO LCOME T THE REPORT ..............................................1 6. RESEARCH .............................................................78 FOREWORDS FROM THE INTERIM DEAN AND THE HEAD 1. Research groups in the department ........................ 78 OF DEPARTMENT .............................................................2 2. Accredited Research Units ............................................... 79 3. Capacity building in research ......................................... 79 4. Publications .............................................................................. 80 PART I .......................................................... 5 5. Grants ........................................................................................... 80 1. EXECUTIVE SUMMARY .............................................5 6. Awards for research and scholarship ......................... 80 Terms of Reference for this review ............................................7 7. SWOT analysis of Research ............................................... 81 2. INTRODUCTION TO THE DEPARTMENT OF 8. Key evaluation questions set by department PSYCHIATRY AND MENTAL HEALTH .........................9 for self-review ........................................................................... 81 The Vision ............................................................................................. 10 9. Findings in relation to questions ................................ 82 Strengths and weaknesses of the Department ............. 10 10. Draft improvement plan for this function .............. 82 7. TEACHING & LEARNING .........................................84 PART II ........................................................12 1. Vision and goals ..................................................................... 84 3. OuR HOSPITALS .....................................................12 2. Under graduate Medical Training ................................. 84 3. P ostgraduate Psychiatric Training ................................ 85 1. Alexandra Hospital ................................................................ 12 4. SWOT analysis of Teaching & Learning ..................... 87 2. Groote Schuur Hospital...................................................... 14 5. Key evaluation questions set by department 3. Lentegeur Hospital ............................................................... 16 for self-review ........................................................................... 87 4. Red Cross War Memorial Children’s Hospital ........ 18 6. Findings in relation to questions .................................. 88 5. New Somerset Hospital ..................................................... 20 7. Draft improvement plan for this function .............. 88 6. Valkenberg Hospital ............................................................. 22 8. TRANSFORMATION ................................................89 4. OUR DIVISIONS.......................................................25 1. Departmental definition of transformation .......... 89 1. Division of Addiction Psychiatry .................................. 26 Transformation in the Department of Psychiatry 2. Division of Child and Adolescent Psychiatry ........ 30 and Mental Health ................................................................ 90 3. Division of Forensic Mental Health ............................. 37 2. Departmental response to transformation .......... 91 4. Division of Intellectual Disability Mental Health 39 3. Departmental Statistics relating to 5. Division of General Adult Psychiatry .......................... 45 Transformation ........................................................................ 92 6. Division of Liaison Psychiatry ........................................ 49 4. SWOT analysis of Transformation ................................. 93 7. Division of Neuropsychiatry ........................................... 53 5. Key evaluation questions set by department 8. Division of Psychopharmacology and for self-review ........................................................................... 94 Biological Psychiatry ............................................................ 58 6. Findings in relation to questions .................................. 94 9. Division of Psychotherapy ..............................................