Intersectoral team members’ understanding of and recommendations for a mental health promotion programme in a rural sub-district, Western Cape Province

Abstract

Mental health and health promotion are in a dire state worldwide. Urgent action is required to ensure that mental health does not further cripple an already overburdened mental health system, specifically in South Africa. For the sub-district of Cape Agulhas in the Western Cape Province, mental health promotion is a challenge due to a lack of resources exclusively available for mental health and a curative focus on treating mental illness rather than preventing and promoting mental health. Intersectoral collaboration in rural districts is essential to promote mental health in the Cape Agulhas sub-district. However, there is a lack of published literature on the intersectoral team members' knowledge of mental health promotion, specifically in the Cape Agulhas sub-district. Therefore, the need for a qualitative study to help unpack the intersectoral team members' knowledge of mental health promotion in the Cape Agulhas sub-district was identified. This led to the research questions “what is the intersectoral team members' understanding of mental health promotion, and what are their recommendations for a mental health promotion program in the rural Cape Agulhas sub-district of the Western Cape.” A qualitative descriptive design was used to gather data on an intersectoral team’s knowledge regarding mental health promotion. This approach enabled a straightforward yet rich description. Data collection included online asynchronous semi-structured interviews combined with photographs through the social media communication application of WhatsApp. Ethical clearance was obtained from the Health Research Ethics Committee of the Faculty of Health Sciences, North-West University (NWU-00477-20-S1). In addition, the researchers obtained permission from the Western Cape Department of Health, the Department of Education, the Department of Social Development, and the Cape Agulhas Municipality. Four (4) themes, 13 categories and 41 sub-categories emanated from the data and the categories were also mapped to the Socio-ecological Model (SEM) of Stokols (1996:285). The results indicate that the intersectoral team in the Cape Agulhas sub-district tended to have reasonable knowledge of which inter-and intrapersonal dynamics are required for a mentally healthy person. The four themes identified were i) the dynamics of a mentally healthy person, ii) an inclusive mental health system, iii) Mental health promotion and education, and iv) leaders should be knowledgeable regarding mental health with a platform to share. It was clear, however, that the intersectoral team’s knowledge of the social determinants of mental health and their role in addressing these to ensure mental health promotion as leaders in the community was lacking. All

the photos that were acquired through photovoice confirmed this statement. A unique finding from the data is that the intersectoral team expressed a need for training to act as leaders in promoting mental health, particularly in a rural context. They also indicated a need for training and education regarding the social determinants of health and how these impacts mental health promotion.