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

Authors:
Professor Arvin Bhana, PhD
Professor Arvin Bhana, PhD
Health Systems Research Unit, Medical Research Council
Chief Research Specialist
Child and adolescent mental health, public mental health, screening brief interventions, resilience
Durban, KwaZulu-Natal | South Africa

Br J Psychiatry 2016 Jan 7;208 Suppl 56:s29-39. Epub 2015 Oct 7.

Inge Petersen, PhD, School of Applied Human Sciences, University of KwaZulu-Natal, Durban, South Africa; Lara Fairall, PhD, Knowledge Translation Unit, University of Cape Town, Cape Town, South Africa; Arvin Bhana, PhD, Tasneem Kathree, MSocSci, One Selohilwe, MSocSci, Carrie Brooke-Sumner, MSc, School of Applied Human Sciences, University of KwaZulu-Natal, Durban, South Africa; Gill Faris, MPhil, Knowledge Translation Unit, University of Cape Town, Cape Town, South Africa; Erica Breuer, MPH, Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa; Nomvula Sibanyoni, MSocSci, National Department of Health, Pretoria, South Africa; Crick Lund, PhD, Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa, and Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; Vikram Patel, PhD, Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK and Centre for Mental Health, the Public Health Foundation of India, India.

Background: In 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.

Aims: To develop a district mental healthcare plan (MHCP) in South Africa that integrates mental healthcare for depression, alcohol use disorders and schizophrenia into chronic care.

Method: Mixed 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.

Results: Collaborative 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.

Conclusions: The 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.

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Source
http://dx.doi.org/10.1192/bjp.bp.114.153726DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4698554PMC
January 2016
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13 Citations
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