Perceptions of primary health care facility managers towards the integration of mental health into primary health care : a study of the Tswane District, Gauteng Province

Abstract

The integration of mental health care (MHC) into primary health care (PHC) has been identified as a practical intervention to: increase accessibility to mental health care; reduce stigma and discrimination against people living with mental illnesses; improve the management of chronic mental illness; and, to reduce the burden of comorbidity of mental illnesses with other chronic illnesses. In the South African context, integrating MHC into PHC also seeks to respond to numerous legislative reforms, with the aim of providing comprehensive health care, particularly to previously disadvantaged populations. The aim of the present study was to explore the perceptions of facility managers in the Tshwane District (Gauteng Province) towards the integration of mental health into PHC. Fifteen participants from the Tshwane district facilities participated in the study. The participants were selected through a non-probability purposive sampling method. Data was collected through in-depth interviews using a semi-structured questionnaire, and analysed using the thematic coding approach. Significant findings suggested that the major hindrances to the realisation of the policy objectives may be due to: the lack of rehabilitation and psychotherapeutic services; insufficient skill and knowledge of mental health on the part of staff; insufficient or unsuitable practice space in the facilities; and, poor cooperation between South African Police Services, Emergency Medical Services and Primary Health Care. Inter-facility communication, district implementation support and policy knowledge has notably increased over the years and were deemed to be amongst the biggest enablers.