Integrating mental health into chronic care in South Africa: The development of a district mental healthcare plan

Abstract

BackgroundIn South Africa, the escalating prevalence of chronic illness and its high comorbidity with mental disorders bring to the fore the need for integrating mental health into chronic care at district level.AimsTo develop a district mental healthcare plan (MHCP) in South Africa that integrates mental healthcare for depression, alcohol use disorders and schizophrenia into chronic care.MethodMixed methods using a situation analysis, qualitative key informant interviews, theory of change workshops and piloting of the plan in one health facility informed the development of the MHCP.ResultsCollaborative care packages for the three conditions were developed to enable integration at the organisational, facility and community levels, supported by a human resource mix and implementation tools. Potential barriers to the feasibility of implementation at scale were identified.ConclusionsThe plan leverages resources and systems availed by the emerging chronic care service delivery platform for the integration of mental health. This strengthens the potential for future scale up.

Suicidal ideation and behaviour among community and health care seeking populations in five low- and middle-income countries: a cross-sectional study

“…In high-income countries, screening for depression and suicidal ideation and treatment of depression are evidence-based risk reduction strategies (Fleischmann et al , 2016, Mann et al , 2005). Moreover, primary care health facilities increasingly are a setting for mental health care in LMIC (Fekadu et al , 2016, Jordans et al , 2016, Kigozi et al , 2015, Lund et al , 2015, Petersen et al , 2016, Shidhaye et al , 2016). …”

Autism spectrum disorder in sub‐saharan africa: A comprehensive scoping review

“…Whilst the lack of data about ASD in SSA presented in this scoping review and noted elsewhere in the literature [Abubakar, 2016; Elsabbagh et al, ; van Schalkwyk, Beyer, & de Vries, ] risk presenting a bleak and insurmountable scenario, we propose that, from a global health perspective, SSA may present many unique and exciting opportunities to contribute to the ASD knowledge‐base and to make a meaningful clinical impact. The very low baselines in clinical services, knowledge, and pathways to care may present unique opportunities to develop clinical care, training programmes and integrated health/education systems “from the ground up” using community‐based participation and high‐quality implementation science approaches [Bird et al, ; Bowen et al, ; Lund, Tomlinson, & Patel, ; Petersen et al, ; Proctor et al, ]. Another compelling opportunity in SSA may be integration of genetic/genomic and environmental data (Abubakar et al, ).…”

Pharmacotherapeutic interventions for bipolar disorder type II: addressing multiple symptoms and approaches with a particular emphasis on strategies in lower and middle-income countries

“…• There are concerns with the lack of health-care professionals managing patients with mental disorders in the public sector in South Africa, which represents the largest proportion of patients in South Africa (approximately 84%) [220,221,252]. • Currently, the majority of psychiatrists in South Africa work in the private sector (approximately 60%) causing problems in the public sector [222].…”