Perceptions of nurses working in primary health care facilities on the implementation of the national mental health policy framework and strategic plan 2013-2020 in OR Tambo district in the Eastern Cape province
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Date
2018-10-09
Authors
Phomane, Mafoko
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Abstract
Introduction
The South African National Mental Health Policy Framework (MHPF) is widely regarded as
South Africa's first official mental health policy and is an important tool for the implementation
of the Mental Health Care Act of 2002. Primary healthcare nurses have been responsible for
the promotion of mental health including detecting and screening of mental health disorders as
well as treating people with mental health conditions. Mental health policies are important
because they coordinate a common vision and plan for all programs and services related to the
provision of mental health services. Without these types of organized guided programs, mental
health services are inefficient and fragmented(1). The aim of the study is to explore the
perceptions of Primary Health Care nurses on the implementation of the National Mental
Health Policy Framework and Strategic Plan 2013-2020 in a rural setting, in Qaukeni Sub-
District in OR Tambo District between 2014-2016. This research is important because it
highlights the need to prioritize mental health service provision at primary health care level, as
the comorbid nature of mental health disorders impacts on other health outcomes. Methods
In order to explore the perceptions of nurses, a cross-sectional qualitative study was done. The
research sample was Professional Nurses working in Primary Health Care Clinics in OR
Tambo’s Ingquza Hill Sub District in the Eastern Cape. Thirteen in-depth one on one interviews
were conducted with participants and their responses were recorded and transcribed. Thematic
analysis was then used to analyze findings. Permission to conduct the study was sought from
relevant authorities; ethics of informed consent, confidentiality and voluntary participation were
utilized.
Results
The findings from this study suggest that mental health services at Primary Health Care Level
are being offered in Ingquza Hill Sub District, however mental health services are not offered
as per what has been outlined in the National Mental Health Policy Framework and Strategic
Plan 2013-2020. Nurses perceptions highlighted that there are varying factors that act as
facilitators as well as barriers to the implementation of the Mental Health Policy. The policy needs to be widely disseminated to those nurses that serve as program implementers. The
following themes emerged during data analysis; access to mental health policies and treatment
guidelines, management of mental illnesses/common mental disorders, training and education
in mental health, supervision of those providing mental health services, limited scope of mental
health services at Primary Health Care level, stakeholder and community awareness on mental
health, knowledge and management of communicable diseases versus mental illnesses (Table
1). The results indicate that the lack of mental health policy implementation may have
implications for access to those who are in need of mental health care services at Primary
Health Care level.
Conclusion
The findings of the study suggest that although mental health services are being provided by
Professional Nurses at this level of care, more interventions such as mental health training and
provision of mental health policies and guidelines need to be put in place by the District to
improve the current level of mental health service provision at Primary Health Care facilities.
The inconsistent varying methods of screening mental illnesses in patients who present at
primary health care clinics indicate that the provision of mental health services in the clinics
visit is not uniform and therefore not in line with policies and guidelines, this has implications
related to access to care for rural mental health care users. Nurses play an important role in
facilitating the provision of mental health services; they however need supportive supervision
from those that have mental health specialist expertise. By exploring the perceptions of nurses working at primary health care facilities on the implementation of the National Mental Health
Policy Framework and Strategic Plan 2013-2020 many current barriers faced by nurses have
been highlighted by this research.
Description
A research report submitted to the School of Public Health, Faculty of Health Sciences,
University of the Witwatersrand Johannesburg, in partial fulfillment of the requirements for the
degree of Master of Public Health in the field of Rural Health, 2018
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Citation
Phomane, Mafoko Margarett (2018) Perceptions of nurses working in Primary Health Care facilities on the implementation of the National Mental Health Policy Framework and Strategic Plan 2013-2020 in OR Tambo District in the Eastern Cape Province, University of the Witwatersrand, Johannesburg, <http://hdl.handle.net/10539/29123>