The Akeso Group launches outpatient programme

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The group, which specialises in behavioural health services in South Africa through its 11 acute psychiatric hospitals, says The Akeso Graduates (TAG) programme is designed to address the risk factors associated with the transitional period immediately post discharge by increasing discharge plan adherence and consolidating dialectical behaviour therapy (DBT) skills.

The DBT approach

DBT is an evidence-based psychotherapy which emphasises a practical, skills-based approach to effectively regulating moods and behaviours.

For almost 20 years, DBT has been seen to be an effective tool in decreasing symptoms relating to trauma, stress, anxiety and depression Medical doctor and specialist psychiatrist, Dr Mike West, explains that the overall aim of the TAG interventions is to assist patients to build lives that feel meaningful and worthwhile.

Recognising early warning signs

According to him, the frequent, and consistent contact provided by programme will allow for clinical assessment for early warning signs relating to readmission and risk of relapse. Some of these important warning signs include difficulties in social or occupational functioning, substance use, self-harm and recurring suicidal thoughts.

Dr West states, “The formalised assessment and reporting process will afford the opportunity to track patients’ progress and collect valuable information through measurement post discharge."

“It is widely held that the low rates of adherence to discharge plans put patients at risk of readmission. However, research from July to December 2012 by South African Depression and Anxiety Group (SADAG), University of the Witwatersrand and Helen Joseph Hospital showed that the introduction of an ongoing support initiative for outpatients significantly increases, by as much as 70%, both medication adherence as well as follow-up appointment attendance.”

Readmissions

Various factors contribute to unplanned readmissions, and often a convergence of several factors may result in certain patients being regularly admitted into hospitals. Oftentimes with these patients, a short-term admission will address immediate problems, but won’t adequately tackle the precipitating and perpetuating problems that generated the admission and that contribute to the chronic nature of the illness.

Also, discharged patients may sooner or later experience the same level of distress and symptoms that brought them to hospital in the first instance. Not continuing with prescribed medication and the lack of a proper and sound support system may furthermore also result in patients being readmitted.

TAG is a one-year programme, with weekly groups in the first three months post discharge, and follow-up sessions after six, nine and 12 months.