Can a brief training intervention help improve mental health service delivery in South Africa?

Abstract

Background: South Africa faces a number of significant challenges apropos mental health service delivery, including a large treatment gap, a high rate of readmission, over-burdened specialist tertiary facilities, and slow integration of mental health into general health services. The South African National Mental Health Education Programme implemented between February 2019 and December 2019, aimed to upskill health workers to diagnose and manage mental disorders at primary and secondary levels of care. Aim: This study aimed to assess the evolution of training participants’ self-reported competency in mental health care and the number of referrals made to higher levels of care as well as to reflect on the possible broader effects of the training. Setting: The programme and study were conducted in South Africa with Medical Officers and Professional Nurses working at public sector primary and secondary level health care facilities. Methods: A descriptive observational study collected data from training participants through a pre- and post-course, and 3-month follow-up survey. Results: The average confidence ratings for performing mental health care activities and managing mental health conditions increased from pre- to post-course, and was either maintained or increased further at 3-month follow-up. A decrease in the self-reported percentage of patients being referred to a higher level of care was observed 3-months after the training. Conclusion: The evaluation suggests that a brief training intervention such this can go a long way in increasing the confidence of primary and secondary level health care workers in managing common mental health conditions and adhering to the provisions of legislation.

Keywords

• primary care
• mental health
• capacity development
• integration of mental health care
• programme evaluation