Suggestions from multidisciplinary team members at a mental health care establishment for integrating mental health services at primary level

Abstract

The integration of mental health care at Primary Health Care level revealed major problems such as lack of dedicated mental health care staff, deficiency of allotted funding, poor accountability for quality service delivery and most professional nurses in PHC facilities do not have a mental health care nursing qualification and are expected to attend to mental health care users (MHCUs). The multidisciplinary team members were interviewed because they experienced an escalation in MHCU numbers as the down referral mechanism, which is in place, does not function. The down referred MHCUs kept coming back to the mental health care establishment (MHCE) and there was also an increase in relapses within three months after discharge of the MHCE. The objective of the study was to explore and describe suggestions from multidisciplinary team members working at the MHCE in a sub-district of the North West Province which could contribute to the successful integration of mental health care services in a sustainable and effective way at PHC level. A qualitative research design was used in this study with explorative, descriptive and contextual strategies. Semi-structured interviews were conducted with doctors, psychologists, different categories of nursing and a dietitian. Content analysis assisted the researcher to derive suggestions for North West Department of Health, the health district and sub-district to integrate mental health care services at PHC level for their perusal.