PERCEPTIONS OF NURSES ON INTEGRATING MENTAL HEALTH INTO PRIMARY HEALTH CARE IN THE O.R. TAMBO DISTRICT

Abstract

A majority of the population in South Africa depends on public health care due to an unequal health system. The most accessible and affordable health care services are through primary health care, which are often public institutions and therefore closer to the people that need them. Integrating mental health care into the primary health care system has been shown to significantly improve mental health care accessibility in the Global North. This research aimed to explore nurses' perceptions of integrating mental health into primary health care in a Global South setting in South Africa at the OR Tambo District Health. The research followed a qualitative research approach to gain more insight into the nurses' perceptions on integrating mental health into the primary health system. The study followed a phenomenological design within a social constructivist paradigm. The research was conducted in four primary health care facilities in the district, involving 12 professional nurses who met the inclusion criteria. Inclusion criteria required participants to be registered professional nurses with a major in psychiatry, possessing at least three years of experience in mental health service delivery within a PHC setting. The selected nurses were directly responsible for assessing, managing, and providing mental health care services to patients within PHC facilities, including screening for mental health conditions, offering basic counselling, administering psychiatric medication, and referring patients to specialized mental health services when necessary. Nurses without psychiatric training or not actively involved in providing mental health care within PHC facilities were excluded. Purposive sampling was used to select participants. Data collection involved in-depth, semi-structured interviews, transcribed verbatim and analyzed using thematic analysis to uncover shared meanings. Measures to ensure trustworthiness included credibility, dependability, conformability, and transferability. Ethical principles, such as informed consent, confidentiality, and beneficence, were strictly adhered to throughout the study. The study's key findings indicated that the integration of mental health into primary health is beneficial as it increases mental health care accessibility, mental health early detection and fosters comprehensive treatment. However, issues such as stigma, lack of trained professionals, and lack of specialists or other health practitioners make it challenging to implement effective integration of mental health into primary health. The study recommends a collaborative effort between the private and public health sectors for effective mental health care services and a follow-up study with a larger sample focusing on more than two Districts.