INTRODUCTION:
The study explored the revolving door phenomenon in psychiatric care, where people living with serious mental illness experience repeated hospital admissions. Repeated admissions indicate challenges in achieving sustained stabilisation and continuity of care. The study focused on patterns of readmission and contributing factors in the Sedibeng district.

METHODS:
A mixed-methods study approach was used. Quantitative data were collected through a retrospective review of psychiatric admission books covering all admissions over a six-month period. Additional quantitative data were obtained through telephonic structured interviews. Qualitative data were collected through in-depth interviews with mental health service users and healthcare providers. Data were analysed to identify patterns of readmission and factors contributing to repeated hospitalisation.

RESULTS:
The findings show that people living with serious mental illness are readmitted within 3 to 6 months following discharge. Repeated admissions are associated with poor treatment adherence, co-occurring substance use, insufficient community-based mental health care, and living arrangements that provide inadequate support after discharge. Health system constraints also contribute to the revolving door phenomenon. Shortages of psychiatric beds and inadequate staffing levels result in early discharges and insufficient stabilisation, leaving healthcare providers struggling to balance limited resources with patient safety.

CONCLUSIONS:
The revolving door phenomenon in psychiatric care in the Sedibeng district is driven by patient-related, social-related and system-level factors. Reducing repeated psychiatric admissions requires strengthened community-based mental health services, improved post-discharge support, and interventions to address resource constraints within inpatient psychiatric care.