Perceptions of nurses on the significance of integrating mental health into primary care in the Dr. Kenneth Kaunda District.
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Due to the huge burden of mental health especially in low- and middle-income countries, there is an increasing shift in mental health policy and practice towards a more comprehensive and integrated health care system. This includes task-shifting whereby non-specialists and other health care resources are leveraged for more effective mental health care service delivery. Central to the success of any comprehensive mental health care which integrates mental health into primary health care is the role of nurses and community health workers who are the backbone of such systems. Thus, it is important to understand their role, experiences and attitudes towards task-shifting and integration of mental health into primary healthcare. This is an area with very limited coverage in research literature. Therefore, this study aimed to investigate the attitudes of health care workers towards integration and the ways this could expand their roles through task-shifting. It also examined the level of knowledge about mental health disorders among nurses, with a focus on psychotic disorders, depression, maternal depression, and alcohol use disorder. The study involved in-depth interviews conducted with nurses in selected clinics at the Dr Kenneth Kaunda district of the North West province of South Africa as part of the PRogramme for Improving Mental Health CarE in South Africa (PRIME-SA) intervention. Results show that nurses generally had positive and receptive attitudes towards the idea of task-shifting and integration, which they believed had several advantages. They also showed strong willingness and interest in working with mental health patients. However, the nurses had generally rudimentary and inadequate knowledge of mental health disorders. Within the framework of this limited knowledge, they knew less about psychotic disorders than they did about depression, maternal depression and alcohol use disorders. They also knew less about alcohol use disorders than they did about depression. The study also shows that participants felt that they had insufficient training on mental health care and that this impacted negatively on their ability to assist mental health patients. It is suggested that a further large-scale study is required to better understand the issues highlighted by this study.