Practitioners’ experience of the integration of mental health into primary health care in the West Rand District, South Africa

Abstract

Background: Despite the alarming prevalence of neuropsychiatric disorders in South Africa, mental health care remains under-resourced. The Mental Health Framework Policy of South Africa outlined the objective to integrate mental health into primary health care. The aim is to make mental health care more accessible, affordable and acceptable. Practitioners, however, find the application of the policy challenging. The identification of challenges can guide efforts to create conditions favourable to the implementation of the policy.

Aim: To explore and describe primary health practitioners’ experience of the integration of mental health into primary health care.

Methods: A mixed-method exploratory descriptive design was used to collect quantitative data by means of a structured questionnaire from a purposive sample consisting of 95 primary health care practitioners and qualitative data from a sub-sample of 12 participants by means of semi-structured interviews. Data were analyzed using mixed-method analysis.

Results: The results indicated that though progress has been made in the implementation of the integration of mental health into primary health care, several challenges remain.

Conclusions: The identified challenges may contribute to inconsistent care and difficulties such as unidentified symptoms, defaulting treatment and the revolving-door phenomenon. Recommendations were made based on the findings of the study.

Keywords:

• integration
• practitioners’ experience
• primary health
• mental health
• South Africa

Acknowledgements

The author gratefully acknowledges contributions from the field workers specifically Louis Wiese, Melanie Govender, Salva Laka, Buyiswa Makhombe, Sosthenius Mafa and Ellen Mtembu for their assistance in collecting, transcribing and reflecting on the data.

Declaration of interest

No potential conflict of interest was reported by the author(s).