Abstract

BackgroundSince the publication of the White Paper for the Transformation of the Health System in South Africa in 1997, which included Policy on Integration of Mental Health Care into primary health care (PHC), there has been an emphasis on the promotion of health as well as the re-engineering of PHC to include the integration of mental health care into PHC. Although South Africa has made significant advances at the level of health-related policy development and legislation in trying to bring the country in line with international trends, there have been challenges with regard to implementation of policies, including that of integration of mental health care into PHC.ObjectivesThe aim of this study was to determine the challenges affecting the implementation of the Policy on Integration of Mental Health Care into PHC in KwaZulu-Natal (KZN) province of South Africa and to seek possible solutions.MethodA qualitative exploratory descriptive design was used to determine the challenges affecting the implementation of the Policy on Integration of Mental Health Care into PHC in KZN. The sample consisted of 42 participants of whom 4 were PHC managers, 6 were operational managers and 22 were professional nurses who were directly involved in implementing the policy at the operational level.ResultsThe challenges identified included lack of training in mental healthcare services for staff working in PHC, unavailability of mental health policies, inadequate resources, poor communication between management and staff, lack of skills among PHC nurses in identifying signs of mental illness and misdiagnosis of patients.ConclusionConsidering the challenges pertaining to PHC nurses’ abilities and skills to implement the Policy on Integration of Mental Health Care into PHC, PHC-trained nurses should engage in lifelong learning and be encouraged to develop their knowledge, skills and competence throughout their professional lives.

Highlights

  • Despite the efforts of bringing South African health-related policy development and legislation in line with international trends, there have been many challenges with regard to implementation of policies, including the integration of mental healthcare into primary healthcare (PHC) (Burns 2008:1; Dube & Uys 2015:2; Kigozi & Ssebunnya 2009:37)

  • The study revealed that the phenomenon of integration of mental healthcare into PHC was seen by PHC-trained nurses as provision of comprehensive care that is either given through a supermarket approach or a one-stop-shop approach, depending on the availability of PHC nurses with a qualification in psychiatric nursing

  • This is consistent with the findings of Lund et al (2012:403) who reported that some mental healthcare users are seen by registered nurses who do not have a qualification in Psychiatric Nursing Science and further argue that this practice may lead to mental healthcare users being misdiagnosed, leading to a relapse of mental illness

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Summary

Introduction

Despite the efforts of bringing South African health-related policy development and legislation in line with international trends, there have been many challenges with regard to implementation of policies, including the integration of mental healthcare into primary healthcare (PHC) (Burns 2008:1; Dube & Uys 2015:2; Kigozi & Ssebunnya 2009:37). The Policy on Integration of Mental Health Care into PHC in South Africa was published together with the White Paper for the Transformation of the Health System in South Africa in 1997 (Republic of South Africa 1997). South Africa has made significant advances at the level of health-related policy development and legislation in trying to bring the country in line with international trends, there have been challenges with regard to implementation of policies, including that of integration of mental health care into PHC. The new health system emphasised prevention and promotion instead of being curative and hospital orientated

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