Challenges affecting the implementation of the Policy on Integration of Mental Health Care into primary healthcare in KwaZulu-Natal province

• Published in: Curationis (Pretoria) Vol. 42; no. 1; pp. 1 - 9
• Main Authors: Hlongwa, Esther N., Sibiya, Maureen N.
• Format: Journal Article
• Language: English
• Published: South Africa AOSIS 2019; African Online Scientific Information Systems (Pty) Ltd t/a AOSIS; AOSIS (Pty) Ltd; Democratic Nursing Organisation of South Africa (DENOSA)
• Subjects: Biology; Comprehensive care integration; Continuing education; Delivery of Health Care, Integrated - methods; Delivery of Health Care, Integrated - trends; Diagnostic errors; Evidence-based nursing; Focus Groups - methods; Health care industry; Health care policy; Health Care Sciences & Services; Health policy; Health Policy & Services; Health-related policies; Humans; Integration of care; Interviews as Topic - methods; Medical personnel training; Mental disorders; Mental health; Mental health care; Mental Health Services; Mental healthcare; Nurses; Nursing; Original Research; Primary care; Primary health care; Primary Health Care - methods; Primary Health Care - trends; Primary healthcare; Program Development - methods; Psychiatric-mental health nursing; Qualitative Research; Service integration; South Africa; Trends; South Africa; KwaZulu-Natal Province South Africa; primary healthcare; integration of care; health-related policies; mental healthcare; comprehensive care integration; service integration
• ISSN: 0379-8577; 2223-6279; 2223-6279
• DOI: 10.4102/curationis.v42i1.1847

Background: Since 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.Objectives: The 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.Method: A 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.Results: The 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.Conclusion: Considering 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.