Abstract
Over the past two decades, the value and benefits of integrated mental health care services have been increasingly recognised. Despite the potential benefits, barriers exist at primary care level to receiving mental health care services, interfering with continuity of care. We conducted semi-structured interviews with mental healthcare users at a primary care clinic in South Africa, to explore their experiences of receiving mental health care services. A convenience sample of 15 participants identified challenges such as limited infrastructure, organisation, medication, services in local communities, allied mental health care services, communication and long waiting times. Mental health care users felt uncared for and disrespected, especially if they were treated by unskilled and overworked staff. Mental health care users described clinic visits as stressful and frustrating. Mental health care users described marked challenges in mental health care service provision in a South African primary health care setting.
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Allie, S., Egbujie, B. A., Fatti, G., Grimwood, A., Mothibi-Wabafor, E. C., Oyebanji, O., et al. (2018). Impact of 'ideal clinic' implementation on patient waiting time in primary healthcare clinics in Kwazulu-natal province, South Africa: A before-and-after evaluation. SAMJ: South African Medical Journal, 108(4), 311–318.
Connelly, L. M. (2013). Grounded theory. Medsurg Nursing, 22(2), 124.
Cypress, B. S. (2015). Qualitative research: The "what," "why," "who," and "how"! Dimensions of Critical Care Nursing : DCCN, 34(6), 356–361.
DiCicco-Bloom, B., & Crabtree, B. F. (2006). The qualitative research interview. Medicine Education, 40(4), 314–321.
Docrat, S., Besada, D., Cleary, S., Daviaud, E., & Lund, C. (2019). Mental health system costs, resources and constraints in south africa: A national survey. Health Policy Plan, 34(9), 706–719.
Dookie, S., & Singh, S. (2012). Primary health services at district level in South Africa: A critique of the primary health care approach. BMC Family Practice, 13, 67.
Dube, F. N., & Uys, L. R. (2015). Primary health care nurses' management practices of common mental health conditions in Kwazulu-natal, South Africa. Curationis, 38(1), 1–10.
Erlingsson, C., & Brysiewicz, P. (2013). Orientation among multiple truths: An introduction to qualitative research. African Journal of Emergency Medicine, 3(2), 92–99.
Hanlon, C., Fekadu, A., Jordans, M., Kigozi, F., Petersen, I., Shidhaye, R., et al. (2016). District mental healthcare plans for five low- and middle-income countries: Commonalities, variations and evidence gaps. The British Journal of Psychiatry: The Journal of Mental Science., 208(Suppl 56), 47–54.
Hanlon, C., Luitel, N. P., Kathree, T., Murhar, V., Shrivasta, S., Medhin, G., et al. (2014). Challenges and opportunities for implementing integrated mental health care: A district level situation analysis from five low- and middle-income countries. PLoS ONE, 9(2), 1–12.
HealtheNews Policy: National mental health policy framework and strategic plan 2013–2020. (2014). @HealtheNews [updated 2014–10–23]. Retrieved September 14, 2018 from https://www.health-e.org.za/2014/10/23/policy-national-mental-health-policy-framework-strategic-plan-2013-2020/.
Integrating mental health into primary care. (2009). A global perspective. Journal of Nervous and Mental Disease, 197(10), 791.
Johnson, J., Hall, L. H., Berzins, K., Baker, J., Melling, K., & Thompson, C. (2018). Mental healthcare staff well-being and burnout: A narrative review of trends, causes, implications, and recommendations for future interventions. International Journal of Mental Health Nursing, 27(1), 20–32.
Liamputtong, P. (2009). Qualitative data analysis: Conceptual and practical considerations. Health Promotion Journal of Australia: Official Journal of Australian Association of Health Promotion Professionals, 20(2), 133–139.
Lund, C., Kleintjes, S., Kakuma, R., Flisher, A. J., & the MRPC. (2010). Public sector mental health systems in South Africa: Inter-provincial comparisons and policy implications. Social Psychiatry and Psychiatric Epidemiology, 45(3), 393–404.
Lund, C., Petersen, I., Kleintjes, S., & Bhana, A. (2012). Mental health services in south africa: Taking stock. African Journal of Psychiatry, 15(6), 402.
Marais, D. L., & Petersen, I. (2015). Health system governance to support integrated mental health care in South Africa: Challenges and opportunities. International Journal of Mental Health Systems, 9, 14.
McCabe, M. P., & Leas, L. (2008). A qualitative study of primary health care access, barriers and satisfaction among people with mental illness. Psychology, Health& Medicine, 13(3), 303–312.
Mental health care act 17 of 2002|South African Government. (2002). Retrieved from https://www.gov.za/documents/mental-health-care-act.
Peters, S. (2010). Qualitative research methods in mental health. Evidence-Based Mental Health, 13(2), 35–40.
Petersen, I., Bhana, A., Campbell-Hall, V., Mjadu, S., Lund, C., Kleintjies, S., et al. (2009). Planning for district mental health services in south africa: A situational analysis of a rural district site. Health Policy Plan, 24(2), 140–150.
Petersen, I., Fairall, L., Bhana, A., Kathree, T., Selohilwe, O., Brooke-Sumner, C., et al. (2016). Integrating mental health into chronic care in South Africa: The development of a district mental healthcare plan. The British Journal of Psychiatry: The Journal of Mental Science, 208(Suppl 56), 29–39.
Petersen, I., & Lund, C. (2011). Mental health service delivery in south africa from 2000 to 2010: One step forward, one step back. South African Medical Journal, 101(10), 751–757.
Saxena, S., & Skeen, S. (2012). No health without mental health: Challenges and opportunities in global mental health. African Journal of Psychiatry, 15(6), 397–400.
Schierenbeck, I., Johansson, P., Andersson, L., & van Rooyen, D. (2013). Barriers to accessing and receiving mental health care in eastern Cape, South Africa. Health and Human Rights, 15(2), 110–123.
Schwandt, T. A., Lincoln, Y. S., & Guba, E. G. (2007). Judging interpretations: But is it rigorous? Trustworthiness and authenticity in naturalistic evaluation. New Directions for Evaluation, 2007(114), 11–25.
Shenton, A. K. (2004). Strategies for ensuring trustworthiness in qualitative research projects. Education for Information, 22(2), 63–75.
van Deventer, C., Couper, I., Wright, A., Wright, A., Tumbo, J., & Kyeyune, C. (2008). Evaluation of primary mental health care in north west province : A qualitative view. South African Journal of Psychiatry, 14(4), 5.
Van Heerden, M. S., Hering, L., Dean, C., et al. (2008). Providing psychiatric services in general medical settings in south africa - mental health-friendly services in mental health-friendly hospitals : Editorial. The South African Journal of Psychiatry, 14(1), 4–6.
Van Staden, C. W., & Krüger, C. (2003). Incapacity to give informed consent owing to mental disorder. Journal of Medical Ethics, 29(1), 41–43.
WHO Mental health atlas. (2017). World Health Organization. [updated 2019–01–21 10:32:02]. Retrieved from https://www.who.int/.
Acknowledgements
The authors are grateful to Dr L Razwiedani, Chairperson of the Tshwane Research Committee for enabling the research at the clinic and to Dr C Tosh, Science editor at the Faculty of Health Sciences, University of Pretoria, for role as science and language editor.
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This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
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Baker, N., Naidu, K. The Challenges Faced by Mental Health Care Users in a Primary Care Setting: A Qualitative Study. Community Ment Health J 57, 285–293 (2021). https://doi.org/10.1007/s10597-020-00647-y
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DOI: https://doi.org/10.1007/s10597-020-00647-y