Abstract
The records of all new cases presenting to two child psychiatry clinics (at four locations) in Johannesburg during 1997 have been entered into a database and analyzed to assist in the development of services, to improve clinical practice and to facilitate research. Results are presented for demographic data, referral sources, presenting complaints, psychosocial stressors and diagnoses. Initial analysis of the results indicates that further research is necessary into the prevalence of anxiety disorders, the effects of regular exposure to high levels of violence and the effects of multiple substitute parents. The study highlights trends and indicates where strategies are necessary to direct resources and to initiate prevention. The high case load of school-related disorders (including learning disorders and attention deficit disorder) demonstrates the need for the educational authorities to review current educational practices. The absence of a clear referral process from primary to secondary to tertiary results in an overload on the clinics and must be urgently addressed. In addition, intersectoral liaison between health, welfare, education and justice departments must be developed in order for children to receive the best care possible.