Knowledge, confidence, and practices of clinical associates in the management of mental illness.

Abstract

Additional human resources are needed to provide mental health services in underserved areas in South Africa (SA). Clinical associates, the mid-level medical worker cadre in SA, could potentially be used to deliver these services. The study explored the self-reported knowledge, confidence, and current practices of clinical associates related to mental health assessment and management. South Africa. A cross-sectional study was conducted. The link to the electronic questionnaire was distributed to clinical associates via databases and social media. Data were analysed with Stata v17. Of the 209 participants, 205 (98.1%) indicated they had training on management of patients with mental illness during their undergraduate degree and 192 (91.9%) had a mental health rotation. Few (10.7%) had any additional mental health training. Most participants rated their knowledge of priority mental disorders as 'good' or 'excellent'. Only 43.2% of the participants felt quite or very confident to perform a mental health examination. Participants who felt quite or very confident to manage patients presenting with suicide risk, aggression, and confusion were 44.9%, 46.9% and 53.1%, respectively. Factors associated with a confidence score of 75% and higher were male gendered, working in Gauteng or Northern Cape provinces, and in a rural area. The majority of participants were already involved in mental health assessment and management in their current work. Clinical associates have a contribution to make in mental health service provision, but this may need to be supplemented by additional practical training. Potential gaps in training have been identified.