Managing mental health disorders: Experiences of primary care providers in rural South Africa

Abstract

Background: Mental health disorders are increasing globally. In South Africa, primary healthcare (PHC) services are tasked with mental healthcare, with limited resources. A task-sharing approach between PHC role-players has also been met with barriers, including negative attitudes towards mental health care, organisational constraints and insufficiently trained staff. 
Aim: To assess the perceptions and experiences of PHC practitioners in managing common mental health disorders. 
Setting: Primary healthcare facilities in the Garden Route District, South Africa.
Methods: An observational, descriptive study using a cross-sectional survey obtained a representative sample of 130 participants. Redcap© platforms captured data, which were analysed to give frequencies and means using simple descriptive statistics. 
Results: Most participants (68.46%) reported average or below average competence in managing mental health conditions. Out-Patient Departments (OPDs) (68.42%) and PHC clinics (56.25%) found reaching a referral practitioner to be challenging. Waiting times of referred patients were longer at hospital OPDs and clinics than at Community Day Centres. 
Conclusion: Resources allocated to PHC mental health services remained inadequate, while available support structures were underutilised. The presence of a dedicated mental health practitioner at a facility had a direct influence on the experience of the staff in managing these disorders. Policy makers and managers should motivate for training in mental health and empower the PHC system to offer acceptable mental health services, in accordance with national and international guidelines. 
Contribution: This research contributed insights into the current mental health ecosystem in primary care, and the need for increased awareness, training and utilising available resources, which could be useful in similar contexts in sub-Saharan Africa.