Category: Mental Health

Categories : Cardiovascular Disease Mental HealthTags :

A Connection Between Mental Health and Heart Disease, Increased Mortality Risks

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Every 34 seconds, someone in the United States dies from heart disease. As nearly half of the country suffers from some form of cardiovascular disease (CVD), another 1 in 4 adults experience a mental health disorder in their lifetime, signalling an inevitable overlap.

Now, a new report from Emory University shows that certain mental health conditions escalate the risk of developing heart disease by 50–100% – and adverse outcomes from existing heart conditions by 60–170%.

The report, published in The Lancet Regional Health-Europe, summarises cardiovascular health disparities among those diagnosed with depression, anxiety, schizophrenia, bipolar and post-traumatic stress disorders (PTSD). The article is part of a series aiming to raise awareness around disparities in CVD health in four populations: women, the elderly, racial minorities and those with mental health conditions.

Emory University professor Viola Vaccarino, MD, PhD, led this metareview linking mental health conditions to CVD, along with co-authors Amit Shah, MD, and Douglas Bremner, MD, also Emory professors.

The report associated the following conditions and their corresponding risks of developing CVD:

  • Major depression, 72%
  • PTSD, 57%
  • Bipolar disorder, 61%
  • Panic disorder, 50%
  • Phobic anxiety, 70%
  • Schizophrenia, nearly 100%

The research also shows that these conditions are associated with a poorer prognosis, greater risk for readmission and higher mortality from existing heart conditions. For example, major depression more than doubles the mortality rate in those with existing CVD.

Additionally, the report emphasises a bidirectional relationship. “More than 40 percent of those with cardiovascular disease also have a mental health condition,” adds Vaccarino.

The physiology of stress

According to the report, a well-documented relationship exists among depression, schizophrenia, PTSD, and abnormal stress responses in the autonomic nervous system (ANS) and hypothalamic-pituitary adrenal axis (HPA).

The former allows the brain to manage involuntary responses, such as functions of the liver, heart, sweat glands, and eye muscles. ANS also manages both acceleration and deceleration of these functions, regulating inflammatory responses. Since most major organs have ANS nerve endings, this system impacts most bodily functions.

The hypothalamic-pituitary adrenal axis (HPA) also influences immune response and metabolism, which can impact cardiovascular function.

According to the report, dysregulation of these systems creates “adverse downstream effects that can affect cardiovascular risk chronically, including increased inflammation, metabolic abnormalities, high blood pressure, enhanced systemic vascular resistance and autonomic inflexibility.” Inflammation has also been implicated in both the development of heart disease and mental health conditions.

Social determinants and quality of care

The role of social determinants of health in CVD disparities is critical. Those with mental health conditions may face disruptions and barriers in the continuum of care, such as affordability and accessibility. Compromised health literacy or communication can also impede access to health screenings and treatment.

Clinicians could also be challenged to care for patients with certain mental conditions, which can be compounded by stigma and existing models that fragment mental and physical health care. Stigmas are also present in the field of clinical research, where having a mental health condition is often an exclusionary criterion in randomised trials.

Moreover, according to the report, current prediction models don’t account for mental health disorders when forecasting the risk of developing heart disease.

Next steps toward a healthier future

To address the disparities of CVD among people with mental health disorders, the authors recommend an integrated approach with interdisciplinary care encompassing behavioural, mental and cardiovascular health.

“The tight connection between cardiovascular and psychological health warrants changes in the health care system that are more amenable to patients with comorbidities,” says Vaccarino. “A clinical team would be ideal for the care of these patients – a team of specialists, social workers, and nursing staff who work in collaboration to provide multidisciplinary care and resources.” 

The report concludes that closing the health disparity gap upholds the rights of those living with a mental health condition to achieve the highest level of health and fully participate in society. 

Source: Emory University

Categories : Mental HealthTags :

Good Sleep Quality Might be Key for Better Mental Wellbeing in Young Adults

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Study also suggests eating fruit and vegetables and exercising are linked with strong benefits – and fruit and vegetable consumption might compensate for poor sleep

Photo by Eren Li

A new study of young adults has strongly linked better sleep quality with better mental wellbeing, with fruit and vegetable consumption and physical activity also strongly associated with psychological wellbeing. Perhaps surprisingly, the findings also suggest that boosting fruit and vegetable intake could potentially help mitigate the effects on wellbeing of a poor night’s sleep. Dr Jack Cooper, previously from the University of Otago, New Zealand, and colleagues present these findings in the open-access journal PLOS One on August 27, 2025.

Prior research has linked better health behaviours—actions that people can adjust in their lives—to better physical health. Evidence also suggests that health behaviours may be linked to mental wellbeing. However, research on this topic has been limited. For example, studies have typically focused only on mental illness, a separate measure from positive psychological wellbeing, and they typically neglect to consider how different health behaviours might interact to affect wellbeing.

To address these and other gaps, Cooper and colleagues analysed relationships between three health behaviours – sleep quality, eating fruits and vegetables, and physical activity – and psychological wellbeing in adults aged 17 to 25. They used data from three studies: a survey study of 1032 adults in New Zealand, the UK, and the US; a 13-day study of 818 New Zealand adults who were asked to keep a daily diary; and an 8-day diary study of 236 New Zealand adults who also wore Fitbits tracking physical activity.

Across all three studies, better sleep quality was most strongly associated with better mental wellbeing, with fruit and vegetable consumption coming in second. Both behaviours showed benefits even when comparing between different days for the same person – so eating more fruit and vegetables one day was associated with a real-time wellbeing boost. Physical activity – whether measured by FitBits or diaries, which aligned – was also linked to better wellbeing, but mostly when comparing between days for an individual rather than when comparing across individuals.

Links between each of the three behaviors and wellbeing appeared to be independent and additive – which might mean that the more of them you do, the bigger the wellbeing benefit. The only exception: above-average intake of fruits and vegetables appeared to mitigate the effects of a poor night’s sleep, and a good night’s sleep appeared to protect against lower fruit and vegetable intake.

This study used samples of young adults from three countries—the U.K., U.S., and New Zealand—and samples sizes were relatively homogeneous. Future research could address some of these limitations by including participants from additional countries and increasing the sample size to improve generalizability. Although this study could not prove a causative link between these behaviors and mental wellbeing, the authors hope that their findings could inform efforts to improve psychological wellbeing of young adults.

Lead author Dr. Jack Cooper adds: “Young adults don’t have to reach some objective benchmark of healthiness to see wellbeing improvement. Sleeping a little better, eating a little healthier, or exercising even for 10 minutes longer than you normally do was associated with improvements to how you feel that day.”

Senior author Professor Tamlin Conner, of the University of Otago Psychology Department, adds: “Understanding what lifestyle factors support wellbeing can help young adults not just ‘get by’ but thrive during this critical life stage.”

“Of these healthy habits, sleep quality stood out as the strongest and most consistent predictor of next-day wellbeing, but eating fruit and vegetables and being active also helped boost wellbeing”.

“This age group faces unique pressures – such as leaving home, financial stress, educational pressures and social stressors – that can lower happiness. Understanding what lifestyle factors support wellbeing can help young adults not just ‘get by’ but thrive during this critical life stage.

Provided by PLOS

Categories : Mental HealthTags :

Insomnia Patients Report Better Sleep when Taking Cannabis-based Medical Products

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Patients reported better sleep as well as decreased anxiety and pain over 18 months of treatment 

Insomnia patients taking cannabis-based medical products reported better quality sleep after up to 18 months of treatment, according to a study published August 27 in the open-access journal PLOS Mental Health by Arushika Aggarwal from Imperial College London, U.K., and colleagues.

About one out of every three people has some trouble getting a good night’s rest, and 10% of adults meet the criteria for an insomnia disorder. But current treatments can be difficult to obtain, and the drugs approved for insomnia run the risk of dependence. To understand how cannabis-based medical products might affect insomnia symptoms, the authors of this study analysed a set of 124 insomnia patients taking medical cannabis products. They examined the patient’s reports of their sleep quality, anxiety/depression, and quality of life changes between one and 18 months of treatment.

The patients reported improved sleep quality that lasted over the 18 months of treatment. They also showed significant improvements in anxiety/depression as well as reporting less pain. About 9% of the patients reported adverse effects such as fatigue, insomnia, or dry mouth, but none of the side effects were life-threatening. While randomised controlled trials will be needed to prove that the products are safe and effective, the authors suggest that cannabis-based medical products could improve sleep quality in insomnia patients.

Co-author Dr Simon Erridge, Research Director at Curaleaf Clinic, summarises: “Over an 18-month period, our study showed that treatment for insomnia with cannabis-based medicinal products was associated with sustained improvements in subjective sleep quality and anxiety symptoms. These findings support the potential role of medical cannabis as a medical option where conventional treatments have proven ineffective, though further randomised trials are needed to confirm long-term efficacy.”

He adds: “Conducting this long-term study provided valuable real-world evidence on patient outcomes that go beyond what we typically see in short-term trials. It was particularly interesting to observe signs of potential tolerance over time, which highlights the importance of continued monitoring and individualised treatment plans.”

Provided by PLOS

Categories : Mental HealthTags :

People with High Sensitivity Have Greater Mental Health Risk

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New research, led by Queen Mary University of London and published in Clinical Psychological Science, has revealed that highly sensitive people (HSP) are more likely to experience mental health problems compared to individuals who are less sensitive. 

The meta-analysis of 33 studies, the first of its kind, looked at the relationship between sensitivity and common mental health problems such as depression and anxiety. Researchers found there was a significant, positive relationship between the two, concluding that highly sensitive people are more likely to experience depression and anxiety compared to those who are less sensitive.

In the study, sensitivity was defined as a personality trait that reflects people’s capacity to perceive and process environmental stimuli such as bright lights, subtle changes in the environment and other peoples’ moods. Often overlooked in mental health studies and clinical practice, which tend to focus on neuroticism and its association with mental health conditions, this research shows that understanding a person’s sensitivity level is important and can have therapeutic implications. 

People with sensitive personality traits may benefit from different treatment plans

For example, people with more sensitive personality traits may be more likely to benefit from treatment plans which involve techniques such as applied relaxation and mindfulness, which can also prevent relapse. 

Tom Falkenstein, a psychotherapist and a PhD student at Queen Mary University of London, said: “This is the most extensive systematic review on sensitivity and mental health in adolescents and adults to date, and is the first ever meta-analysis on the topic to estimate the impact of this relationship. We found positive and moderate correlations between sensitivity and various mental health problems such as depression, anxiety, post-traumatic stress disorder, agoraphobia and avoidant personality disorder. Our findings suggest that sensitivity should be considered more in clinical practice which could be used to improve diagnosis of conditions.”

“In addition, our findings could help improve treatment for these individuals. Around 31% of the general population are considered highly sensitive, and, as our findings show, are more likely to respond better to some psychological interventions than less sensitive individuals. Therefore, sensitivity should be considered when thinking about treatment plans for mental health conditions. Our work shows it is crucial that the awareness of sensitivity is improved among mental health care professionals, so clinicians and practitioners can recognise the trait in their patients, and tailor treatment to their sensitivity.”

Michael Pluess, Professor in Developmental Psychology at University of Surrey and Visiting Professor at Queen Mary University of London said: “This is the first meta-analysis providing robust evidence that highly sensitive people are more prone to common mental health problems. However, it is important to remember that highly sensitive people are also more responsive to positive experiences, including psychological treatment. Our results provide further evidence that sensitive people are more affected by both negative and positive experiences and that the quality of their environment is particularly important for their well-being.”

The systematic review and meta analysis of 33 studies was carried out by an academic team from several universities including Queen Mary University and the University of Surrey. 

Source: Queen Mary University London

Categories : Mental Health Substance UseTags :

Cannabis Potency May Be Driving a Rise in Schizophrenia

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A new article published in the Canadian Medical Association Journal warns of the mental health dangers stemming from the increasing potency of cannabis. In Ontario, there has been a more than 14-fold increase in risk for visiting the emergency department for cannabis-related schizophrenic disorders. After a cannabis-induced psychotic episode, cessation of cannabis use is necessary to reduce the risk of relapse, and in severe cases, antipsychotics may be needed.

“Cannabis from the 2000s is not the same as in 2025,” said coauthor Dr Nicholas Fabiano, MD, resident and researcher with the Department of Psychiatry, University of Ottawa, Ottawa, Ontario. “THC content has increased by 5 times. This is likely a significant driver in the increasing link between cannabis use and schizophrenia.”

  1. Cannabis potency is increasing — The concentration of tetrahydrocannabinol (THC) has increased fivefold in the last 20 years in Canada from about 4% to 20% in most legal dried cannabis.
  2. High-potency and regular cannabis use is linked to increased risk of psychosis — The risk of psychosis is increased in people using high-potency THC (more than 10% THC), people using it frequently, and those who are younger and male. A history of mental disorders (depression, anxiety, etc) also appears to increase the risk.
  3. Cannabis-induced psychosis and cannabis use disorder increase the risk of schizophrenia — A recent study of 9.8 million people in Ontario found a 14.3-fold higher risk of developing a schizophrenia-spectrum disorder in people visiting the emergency department for cannabis use and a 241.6-fold higher risk from visits for cannabis-induced psychosis.
  4. Treatment requires stopping cannabis and taking medication — Continued use of cannabis after a first episode of cannabis-induced psychosis is linked to greater risk of returning symptoms. Antipsychotic medication can help people with severe and prolonged symptoms.
  5. Behavioural options may help with cannabis cessation — Motivational interviewing or cognitive behavioural therapy by a physician or psychologist can help build skills to resist cravings and follow treatment recommendations.

Source: EurekAlert!

Categories : Mental HealthTags :

Do Claimed Past-life Memories Affect Mental Health?

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In Brazil, belief in reincarnation is common, with up to a third of people believing it is possible. Some claim to have memories of their past lives. Researchers analysed the profile of adults who claim to have past-life memories, the features of these memories, and their associations with mental health, happiness, and religiosity/spirituality. The results indicated a high prevalence of mental disorder symptoms, with religiosity and spirituality being protective factors.

Most religious and spiritual traditions worldwide share a belief in a transcendental realm and/or the continuity of life after physical death. This belief is common among the adult population of 35 countries across six continents, with percentages ranging from 38% in Sweden to 85% in Indonesia.

A recent survey, involving nationally representative samples in 22 countries across all continents, concluded that there are no countries where most of the population said they did not believe in life after death, with the majority answering “yes” or “unsure” to this question.

While there are studies of claims of past-life memories (PLM) in children, there is still little knowledge about cases in adults and the impact of PLM on claimers. To fill this gap, Sandra Maciel de Carvalho and her team analysed the profile of adults who claim to have PLM, including sociodemographic data, the features of these memories, and their associations with mental health, happiness, and religiosity/spirituality.

With support from the BIAL Foundation, researchers from the Federal University of Juiz de Fora (Brazil) and the University of Virginia (USA) performed an online survey for the first time among a sample of 402 adults living in Brazil who reported having memories of past lives. In this country, 66% of citizens say that there is probably, or definitely, life after death, and 33% believe that people will be reborn in this world.

Most of the sample participants were middle age 41.6 years, female (79%), with higher education (68%), Spiritists (54.5%), and very/moderately spiritual (91%). PLM started spontaneously in 82%, on average, at 19.9 years old. Birthmark/defect (54%), unusual philia (intense and unusual attractions or interests; 30%), and phobia in childhood (71%), and persistent phobia (71%) were commonly associated features.

The results were published in the article “Who Does Report Past-Life Memories? Claimers’ Profile, Religiosity/Spirituality and Impact on Happiness and Mental Health”, published in July in the scientific journal The International Journal for the Psychology of Religion and indicated that the PLM features in sample participants are similar to those usually reported among children, except for the female prevalence.

In this sample, childhood philias and phobias were associated with lower happiness and more symptoms of mental disorders (46%), which may indicate a lasting psychological impact associated with PLM. Post-traumatic stress disorder (36%) was associated with phobias. Religion/spirituality was associated with greater happiness and lower mental disorder outcomes, potentially acting as a protective factor.

According to Sandra Maciel de Carvalho, “this study demonstrated that PLM in adults may be more prevalent than previously thought and may be associated with significant suffering and distress”. PLM may constitute a “relevant issue in mental health, and further studies are needed on its prevalence, impact, and proper clinical management”, the researcher emphasises.

Learn more about the project “89/18 – National survey of “Cases of Reincarnation Type” in Brazil” here.

Source: BIAL Foundation

Categories : Mental Health NeurologyTags :

Astrocytes Identified as Hidden Culprit Behind PTSD

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Excessive astrocytic GABA impairs fear extinction in PTSD, new drug target offers hope for treatment

Figure 1. Astrocyte-Derived GABA and Therapeutic Effects of KDS2010 in PTSD. Brain imaging of PTSD patients revealed unusually high levels of GABA and reduced cerebral blood flow in the prefrontal cortex, showing that changes strongly correlated with symptom severity. In animal models, this excess GABA was traced to reactive astrocytes producing it abnormally due to increased MAOB and reduced levels of the GABA-degrading enzyme ABAT. This disrupted normal brain function and impaired the ability to extinguish fear. Treatment with KDS2010, a selective MAOB inhibitor, successfully lowered astrocytic GABA, restored brain activity, and rescued fear extinction, highlighting its potential as a therapeutic option. Credit: Institute for Basic Science

Why do patients with post traumatic stress disorder (PTSD) often struggle to forget traumatic memories, even long after the danger has passed? This failure to extinguish fear memories has long puzzled scientists and posed a major hurdle for treatment, especially since current medications targeting serotonin receptors offer limited relief for only a subset of patients.

In a new discovery, scientists at the Institute for Basic Science (IBS) and Ewha Womans University have uncovered a new brain mechanism driving PTSD – and a promising drug that may counteract its effects. The research is reported in Signal Transduction and Target Therapy.

Led by Dr C. Justin Lee at the IBS Center for Cognition and Sociality and Professor Lyoo In Kyoon at Ewha Womans University, the team has shown that excessive GABA (gamma-aminobutyric acid) produced by astrocytes, which are star-shaped support cells in the brain, impairs the brain’s ability to extinguish fear memories. This deficit is a core feature of PTSD and helps explain why traumatic memories can persist long after the threat has passed.

Crucially, the researchers found that a brain-permeable drug called KDS2010, which selectively blocks the monoamine oxidase B enzyme responsible for this abnormal GABA production, can reverse PTSD-like symptoms in mice. The drug has already passed Phase 1 safety trials in humans, making it a strong candidate for future PTSD treatments.

PTSD remains difficult to treat, with current medications targeting serotonin pathways providing limited relief for many patients. The new study focused on the medial prefrontal cortex (mPFC), a region of the brain critical for regulating fear, and found that PTSD patients had unusually high levels of GABA and reduced cerebral blood flow in this area. These findings emerged from brain imaging studies of more than 380 participants. Importantly, GABA levels decreased in patients who showed clinical improvement, pointing to the chemical’s central role in recovery.

To uncover the origin of this excess GABA, the researchers examined postmortem human brain tissue and used PTSD-like mouse models. They discovered that astrocytes, not neurons, were producing abnormal amounts of GABA via the enzyme monoamine oxidase B (MAOB). This astrocyte-derived GABA impaired neural activity, blocking the brain’s ability to forget traumatic memories.

When the researchers administered KDS2010, a highly selective, reversible MAOB inhibitor developed at IBS, the mice showed normalized brain activity and were able to extinguish fear responses. The drug reduced GABA levels, restored blood flow in the mPFC, and re-enabled memory extinction mechanisms. The study thus confirms astrocytic MAOB as a central driver of PTSD symptoms, and MAOB inhibition as a viable therapeutic path.

A major challenge of the study was linking clinical findings in humans with cellular mechanisms in the lab. The researchers addressed this by applying a “reverse translational” strategy: they began with clinical brain scans and moved backward to identify the cellular source of dysfunction, then confirmed the mechanism and tested drug effects in animal models. This approach led to a new understanding of how glial cells – long thought to be passive – actively shape psychiatric symptoms.

“This study is the first to identify astrocyte-derived GABA as a key pathological driver of fear extinction deficit in PTSD,” said Dr Won Woojin, a postdoctoral researcher and co-first author of the study. “Our findings not only uncover a novel astrocyte-based mechanism underlying PTSD, but also provide preclinical evidence for a new therapeutic approach using an MAOB inhibitor.”

Director C. Justin LEE, who led the study, emphasized that “This work represents a successful example of reverse translational research, where clinical findings in human guided the discovery of underlying mechanisms in animal models. By identifying astrocytic GABA as a pathological driver in PTSD and targeting it via MAOB inhibition, the study opens a completely new therapeutic paradigm not only for PTSD but also for other neuropsychiatric disorders such as panic disorder, depression, and schizophrenia.”

The researchers plan to further investigate astrocyte-targeted therapies for various neuropsychiatric disorders. With KDS2010 currently undergoing Phase 2 clinical trials, this discovery may soon lead to new options for patients whose symptoms have not responded to conventional treatments.

Source: Institute for Basic Science

Categories : Mental Health Obstetrics & GynaecologyTags :

Surrogates Have an Increased Risk of a Mental Illness Diagnosis

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People who are gestational carriers (or “surrogates”) appear more likely to be diagnosed with a new mental illness during and after pregnancy, according to new research from ICES, McGill University, and the Research Institute of the McGill University Health Centre. 

As the number of births by surrogacy increases, this is the first large study using Ontario-based health data to explore the mental health challenges faced by some surrogates. 

Despite guidelines requiring mental health screening, the researchers found that nearly 1 in 5 gestational carriers had a prior mental illness diagnosis before pregnancy—including some with serious conditions that may have made them ineligible to carry a pregnancy for someone else. 

“Our findings underscore the importance of adequate screening and counselling of potential gestational carriers before pregnancy about the possibility of a new-onset mental illness, or exacerbation of a prior mental-illness during or after pregnancy,” says lead author Dr. Maria Velez, an adjunct scientist at ICES, associate professor at McGill University, and scientist at the Research Institute of the McGill University Health Centre. 

The study, published in JAMA Network Open, included 767 406 births at more than 20 week’s gestation in Ontario, Canada between 2012 and 2021 among women without known mental illness before pregnancy. Comparison groups included 97.6% (748,732) who were conceived without assistance, 2.3% (17,916) by IVF and 0.1% (758) using gestational carriers. 

Gestational carriers were more likely to have previously given birth, resided in a lower-income area, and had higher rates of obesity and chronic hypertension. 

Adequate mental health support needed 

The incidence rate per 100 person-years of new-onset mental illness was 5.2 among non-gestational carriers with unassisted conception, 5.0 among non-gestational carriers who conceived by IVF, and 6.9 among gestational carriers. 

The findings were even more pronounced for mental illness that was newly diagnosed through an emergency department encounter or a hospitalisation, compared to an outpatient mental illness diagnosis. 

“Unfortunately, fewer than half of those who visit the emergency room for mental health concerns after childbirth receive timely follow-up care which leaves many, especially gestational carriers, at risk during a vulnerable period,” says Velez. 

The authors say that they hope this study will inform future guidelines that ensure adequate mental health support for gestational carriers during and after pregnancy. 

Source: ICES

Categories : Hospitals Mental HealthTags :

Health Ombud’s Findings on Complications and Deaths of Psychiatric Patients in the Northern Cape

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Pretoria – The Health Ombud, Professor Taole Mokoena, has released the findings of an investigation into the treatment, complications, and deaths of psychiatric patients at the Northern Cape Mental Health Hospital (NCMHH) and the Robert Mangaliso Sobukwe Hospital (RMSH). The investigation revealed that two patients died, and another underwent craniectomy and remains bedridden.

The investigation was initiated following a complaint filed by the Honourable Minister of Health, Dr. Aaron Motsoaledi (MP), regarding the Northern Cape Mental Health Hospitals in October 2024. The reported incidents took place in July and August 2024, during which it was alleged that two patients died at NCMHH, and two others were admitted to RMSH in critical condition.

In response to the Minister’s request, the Health Ombud deployed a team of two investigators in accordance with Section 81(3)(c) of the National Health Amendment Act (NHAA). This investigation report is issued based on Section 81A (11) of the NHAA, 2013 (Act No. 12 of 2013), pertaining to the functions of the Office of Health Standards Compliance and the handling of complaints by the Health Ombud. The report is intended to inform both the complainant and the health establishments as well as the general public of the findings and recommendations derived from the investigation.

ISSUES INVESTIGATED

The investigation was carried out through a detailed analysis and triangulation of information and documentary evidence obtained from the NCMHH and RMSH, as well as through on-site visits. The following issues were identified for investigation based on the analysis of the complaints, allegations, and engagement with both health establishments:

  • The circumstances surrounding Mr. Cyprian Mohoto’s care at NCMHH and his subsequent death at RMSH;
  • The circumstances surrounding Mr. Petrus De Bruins’s care at NCMHH and his admission to RMSH;
  • The circumstances surrounding Mr. Tshepo Mndimbaza’s care and death at NCMHH; and
  • The circumstances surrounding Mr. John Louw’s care at NCMHH and his admission to RMSH.

The investigation revealed that, at the time of the incidents, NCMHH and several neighbouring health facilities were facing challenges with their electricity supply due to cable theft and vandalism at their power substation. This power loss impacted the communication infrastructure, leaving the hospital without telephone lines.

Electricity supply was restored within days at two of the neighbouring hospitals; however, it took an entire year for the electricity to be restored at NCMHH. The investigation found that the delay in repairing the electricity supply to NCMHH was due to dysfunctional Supply Chain Management processes within the Provincial Department of Health. This delay rendered the hospital’s Heating, Ventilation, and Air Conditioning (HVAC) system nonfunctional, exposing patients and staff to extreme weather conditions during the summer and winter. Additionally, because of the lack of electricity, the available resuscitation equipment was not operational, as it could not be charged, and other necessary equipment was unavailable for use. NCMHH procured poor quality pyjamas and blankets which were inadequate to provide warmth to patients during the severe winter’s cold, especially at night.

It was established that the Clinical Manager at NCMHH had written a complaint letter to the Acting Head of the Provincial Department of Health, detailing the adverse conditions which patients at NCMHH were being subjected to. These circumstances negatively impacted their health and violated their human rights.

FINDINGS

The investigation uncovered several findings regarding the medical care of four patients:

  1. Circumstances surrounding Mr. Cyprian Mohoto’s care and admission to RMSH: The investigation revealed gross mismanagement surrounding Mr. Mohoto’s care, which ultimately led to his death. He was admitted to RMSH on 13 July 2024, with a suspected abdominal or bowel obstruction following complications at NCMHH on 12 July 2024. Admission abdominal X-rays ruled out bowel obstruction while the chest X-ray revealed multi-lobar pneumonia. The pneumonia was never treated during the 3 days that the patient stayed in the Surgical Recovery Unit until his death. His deteriorating clinical status was never attended to by either the nursing personnel nor the doctors. Mr. Mohoto died on 16 July 2024, in the Emergency Centre at the Surgical Recovery Unit at RMSH.
  2. Mr. De Bruin was transferred from NCMHH to the Emergency Centre at RMSH on 30 July 2024, after collapsing and being unresponsive in Ward M2 at NCMHH. He was stabilised and later admitted to the RMSH Medical Recovery Unit for hypoglycaemia, the medical care and investigations conducted in the Emergency Centre were appropriate. However, the monitoring by nursing personnel was found to be inadequate.
  3. The Circumstances Surrounding Mr. Tshepo Mdimbaza’s Death: Mr. Mdimbaza was discovered unresponsive in his bed on 3 August 2024, at NCMHH. The resuscitation process was delayed due to the unavailability, malfunction, or unpreparedness of resuscitation equipment. There was also a lack of monitoring of the patient’s vital signs before and during resuscitation by medical or nursing personnel. Mr. Mdimbaza did not survive the resuscitation attempt. The post-mortem report indicated that he died due to “exposure to the elements” at NCMHH.
  4. The investigation into the circumstances surrounding the care and admission of Mr. John Louw to RMSH revealed that he had an acute subdural haemorrhage. An emergency craniotomy and craniectomy were successfully performed on 07 July 2024 and 23 July 2024, respectively, and he was discharged back to NCMHH on 28 October 2024. Mr. Louw remains bedridden.
  5. The investigation also established additional findings, including leadership instability in the Northern Cape Provincial Department of Health, which negatively affected service delivery, safety, and the quality of patient care at NCMHH and RMSH.
  6. Northern Cape Mental Health Hospital was found to have poor governance and systemic lack of leadership and poor management at all levels, unpreparedness for emergency cases, crumbling infrastructure, poor pharmacy and medicine control management, shortage of staff, poor quality assurance management, non-compliance with patient record keeping, and poor laundry services.
  7. Robert Mangaliso Sobukwe Hospital was found to be experiencing critical staff shortage across the board; lack of oversight with nursing supervision; communication breakdown of reporting systems, non-compliance with guidelines on principles of good record keeping and overcrowding at the hospital emergency centre, aggravated by the absence of a district or regional hospital.
  8. The investigation concluded that the general care provided at the Northern Cape Mental Health Hospital and the Robert Mangaliso Sobukwe Hospital to the patients was substandard, and patients were not attended to in a manner consistent with the nature and severity of their health condition, as required by Regulation 5 (1) of the Norms and Standards Regulations Applicable to Different Categories of Health Establishments, 2018 (Norms and Standards Regulations).

RECOMMENDATIONS

The Health Ombud made clear, actionable recommendations to address the systemic failures observed at both health establishments to improve the overall safety and quality of patient care. Key recommendations include; the Provincial Head of Department of Health must immediately appoint a Task Team to monitor the implementation of the recommendations as outlined in the report, hold accountable officials found to be in breach through formal disciplinary processes, the National Department of Health should initiate a forensic investigation into the procurement processes for the NCMHH, priority should be given to the development, reinstatement, and implementation of an effective and efficient reporting system for continuity of care and effective communication, and the development of comprehensive Standard Operating Procedures (SOPs)/Protocols/Guidelines to guide healthcare personnel in providing healthcare services. The complete set of recommendations is included in the report.

A detailed report is available on the Health Ombud’s website at www.healthombud.org.za.

Categories : Mental HealthTags :

New Study Shows Increased Suicide Risk among Healthcare Workers

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A new study from Karolinska Institutet shows that healthcare workers in Sweden have a higher risk of suicide compared to other occupational groups with similar professional levels. The study highlights the risks for physicians, registered nurses, and assistant nurses in particular.

The study, published in Acta Psychiatrica Scandinavica, shows that healthcare workers, especially those working in patient care, have a significantly higher risk of suicide compared to other professions with similar professional qualifications.

Registered nurses had a 61% higher risk of suicide compared to non-healthcare workers. 

Physicians had a 57% higher risk, and among them, psychiatrists stood out with an almost threefold increase in risk.

”Previous studies have mostly focused on physicians and often compared them to the general population, which may have underestimated their risk due to socio-economic differences. This study compared individuals with similar professional levels, which showed that physicians have a significantly higher risk of suicide,” says first author Alicia Nevriana, postdoctoral researcher at the Institute of Environmental Medicine, Karolinska Institutet.

The study included many different occupational roles within healthcare, including administrative staff. The study also highlights that administrative staff in healthcare do not have a higher risk of suicide.

Source: Karolinska Institutet