Use of flow-charts by nurses dealing with mental patients: an evaluation in Lesotho.

General nurses without previous training in psychiatry were instructed, over a period of thirteen hours, in the use of eight flow-charts for the identification and management of mental health conditions. They then prepared management plans, with the aid of the flowcharts, for 105 patients with suspected mental health problems who were seen in three outpatient clinics. The same patients were also seen by trained mental health workers who made a diagnosis and wrote up a management plan, which subsequently was compared with the management plans devised by the nurses.Seventy-eight of the 105 patients (74%) were identified and treated correctly by the nurses. A total of 32 mistakes were made, 17 of which were due to the nurses and 15 to defects in the flow-charts. On the basis of these findings, suggestions are made for improvements in the flow-charts and in the way the nurses are instructed in their use.