Abstract
BackgroundSouth Africa faces a number of significant challenges apropos mental health service delivery, including a large treatment gap, a high rate of readmission, over-burdened specialist tertiary facilities, and slow integration of mental health into general health services. The South African National Mental Health Education Programme implemented between February 2019 and December 2019, aimed to upskill health workers to diagnose and manage mental disorders at primary and secondary levels of care.AimThis study aimed to assess the evolution of training participants’ self-reported competency in mental health care and the number of referrals made to higher levels of care as well as to reflect on the possible broader effects of the training.Setting The programme and study were conducted in South Africa with Medical Officers and Professional Nurses working at public sector primary and secondary level health care facilities.MethodsA descriptive observational study collected data from training participants through a pre- and post-course, and 3-month follow-up survey.ResultsThe average confidence ratings for performing mental health care activities and managing mental health conditions increased from pre- to post-course, and was either maintained or increased further at 3-month follow-up. A decrease in the self-reported percentage of patients being referred to a higher level of care was observed 3-months after the training.ConclusionThe evaluation suggests that a brief training intervention such this can go a long way in increasing the confidence of primary and secondary level health care workers in managing common mental health conditions and adhering to the provisions of legislation.
Highlights
The high burden of mental disorders in South Africa is well-established
South African mental health patients experience high rates of re-admission to tertiary mental health institutions, a phenomenon known as the revolving door syndrome
Eight of the nine South African provinces were represented in the final sample with 16% from the Free State and Mpumalanga, respectively, 14% from the Eastern Cape and Gauteng, respectively, 13% from KwaZulu-Natal, 11% from Limpopo, 7% from the Western Cape, and 4% from the North-West
Summary
The high burden of mental disorders in South Africa is well-established. South African mental health patients experience high rates of re-admission to tertiary mental health institutions, a phenomenon known as the revolving door syndrome. Lund and Peterson found that this is mainly because poor treatment adherence and defaulting; substance abuse; and early discharge because of bed shortages.[8] Poor integration of mental health services into the general health services environment overwhelms the tertiary mental health care system and may contribute to the observed revolving-door phenomenon. South Africa faces a number of significant challenges apropos mental health service delivery, including a large treatment gap, a high rate of readmission, over-burdened specialist tertiary facilities, and slow integration of mental health into general health services. The South African National Mental Health Education Programme implemented between February 2019 and December 2019, aimed to upskill health workers to diagnose and manage mental disorders at primary and secondary levels of care
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