Integration of mental health into PHCs in Johannesburg.

Abstract

ABSTRACT The South African (SA) government recognizes mental health as a serious public health and development concern that warrants the same status as general health. The current legislation of SA emphasizes accessibility of all services to all citizens, including mental health services. It is vital that Integration of mental health into primary health care services be viewed as a priority to address the past injustices brought about by institutional care. New mental health policies are formulated within the framework of the Constitution of the Republic of South Africa of 1996. The White Paper for the Transformation of the Health System in South Africa (1997) makes provision for the integration of mental health into primary health care services in order to improve access to mental health services to the majority of the citizens of the country. The study looks at the factors leading to slow and no integration of mental health into Primary Health Care (PHC) services at Johannesburg Metro (JHB) Health district. The aim of the study was to explore the perceptions, attitudes, knowledge of the health professionals at JHB Metro re integration of mental health into PHC services, their experiences in working with mentally ill persons and problems experienced, as well as solutions. The exploratory study is qualitative in nature. Primary data was collected using in-depth interviews and strategic documents from the Gauteng Department of Health (GDOH). The study describes the main challenges facing the health professionals in integrating mental health into primary health care services that include mainly shortages of trained mental health staff, negative attitudes of PHC staff, lack of support from senior management, shortage of skills in mental health care, poor supply of medicines and lack of family and community involvement. Recommendations to improve access to the mental health care services at the lowest level of care include gaining the support of senior management and addressing attitude issues of PHC staff as identified as the two main problems hindering integration of mental health into PHC services.