Mental health in primary care : integration through in-service training in a South African rural clinic
Date
2018-05
Journal Title
Journal ISSN
Volume Title
Publisher
AOSIS
Abstract
Background: Integrating mental health into primary care is a global priority. It is proposed to
‘task-share’ the screening, diagnosis and treatment of common mental disorders from
specialists to primary care workers. Key to facilitating this is training primary care workers
to deliver mental health care. Mental health training in Africa shows a predominance of
short-term, externally driven training programmes. Locally, a more sustainable delivery
system was needed.
Aim: The aim of the study was to develop and evaluate a locally delivered, long-term, inservice
training programme to facilitate mental health care in primary care.
Methods: This was a quasi-experimental study using mixed methods. The in-service
training programme was delivered in weekly 1-h sessions by local psychiatry staff to
20 primary care nurses at the clinic over 5 months. The training was evaluated using
quantitative data from participant questionnaires and analysis of the referrals from primary
to specialist care. Qualitative data were collected via semi-structured interviews and 14
observed training sessions.
Results: The training was feasible and well received. Referrals to the mental health nurse
increased in quality and participants’ self-rated competence improved. Additional benefits
included the development of supervision skills of mental health nurses and providing a
forum for staff to discuss service improvement. The programme acted as a vehicle to pilot
integration in one clinic and identify unanticipated barriers prior to rollout.
Conclusions: Long-term, in-service training, using existing local staff had benefits to the
integration of mental health into primary care. This approach could be relevant to similar
contexts elsewhere.
Description
CITATION: Maconick, L. et al. 2018. Mental health in primary care: Integration through in-service training in a South African rural clinic. African Journal of Primary Health Care & Family Medicine, 10(1):a1660, doi:10.4102/phcfm.v10i1.1660.
The original publication is available at https://phcfm.org
The original publication is available at https://phcfm.org
Keywords
Mental health care, Primary care, Primary health care, Rural clinic, Mental disorders -- Mental health, Mental health training -- In-service training
Citation
Maconick, L. et al. 2018. Mental health in primary care: Integration through in-service training in a South African rural clinic. African Journal of Primary Health Care & Family Medicine, 10(1):a1660, doi:10.4102/phcfm.v10i1.1660.