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The prevalence and patterns of substance use among psychiatric patients at a tertiary hospital in Tshwane, Gauteng Province, South Africa

Thivhudzwi Hellen Shai · Kebogile Elizabeth Mokwena ORCID ↗ · Mohora Feida Malebatja ORCID ↗

International Journal of Research in Business and Social Science · 2026 · Vol. 15 / Issue 4 · 448-460

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Overview

Abstract

Patients with mental illnesses exhibit disproportionately higher rates of substance use compared to the general population, a pattern that is linked with exacerbation of psychiatric symptoms leading to poorer overall health outcomes. Consequently, a comprehensive understanding of the prevalence and patterns of substance use among psychiatric patients is essential for the development of effective, evidence-based mental health interventions. The study aimed to determine the prevalence and patterns of substance use among psychiatric patients attending a tertiary hospital in Tshwane, Gauteng Province. A cross-sectional quantitative survey was conducted among psychiatric patients, with a sample size of 405. The Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) version 3.1 was used to collect data on substance use, while a quantitative questionnaire was used to collect sociodemographic information; both were analysed descriptively. The findings of this study indicated a high prevalence of substance use, with 70.1% of participants reporting substance use. Furthermore, schizophrenia emerged as the most common psychiatric diagnosis, accounting for 32.6% of cases. Alcohol was the most frequently used substance (60.5%), followed by tobacco (49.9%) and cannabis (26.4%). These results highlight the significant overlap between psychiatric illness and substance use, emphasizing the bidirectional relationship between the two. It is thus concluded that substance use is highly prevalent among psychiatric patients, underscoring the urgent need for integrated treatment approaches that address both psychiatric conditions and substance use disorders to improve clinical outcomes, reduce relapse rates, and enhance overall quality of life.

Keywords: {'name': 'Prevalence'}, {'name': 'Substance Use'}, {'name': 'Psychiatric Patients'}, {'name': 'Mental Health'}

Authors & affiliations

Thivhudzwi Hellen Shai
Sefako Makgatho Health Sciences University

Kebogile Elizabeth Mokwena
Sefako Makgatho Health Sciences University

Mohora Feida Malebatja
Sefako Makgatho Health Sciences University

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