Patient preferences for the integration of mental health counseling and chronic disease care in South Africa
MetadataShow full item record
Purpose: To describe patient perceptions of the acceptability of integrating mental health counseling within primary care facilities in the Western Cape province of South Africa and their preferences for the way in which this care is delivered.
Patients and methods: Qualitative interviews with 30 purposively selected patients receiving treatment for HIV or diabetes within primary care facilities who screened positive for depression using the Center for Epidemiological Studies Depression Scale or hazardous alcohol use through the Alcohol Use Disorders Identification Test.
Results: Participants articulated high levels of unmet need for mental health services and strong associations between poor mental health and the challenges of living with a chronic disease. Consequently, they considered it acceptable to offer screening and mental health counseling within the context of chronic disease care. They thought counseling would be highly relevant if it helped patients develop adaptive strategies for coping with stress and negative emotions. Irrespective of chronic disease, patients indicated a preference for lay counselors rather than existing clinicians as potential delivery agents, supporting a task-shared approach to mental health counseling delivery in primary care settings. Some expressed concern about the feasibility of using lay counselors already present in facilities to deliver this service, suggesting that additional counselors might be needed.
Conclusion: Findings demonstrate a need for mental health counseling within the context of chronic disease care in South Africa. Task-shared approaches, using lay counselors, seem acceptable to patients – provided counselors are selected to ensure they possess the qualities associated with effective counselors. Findings have informed the design of a task-shared mental health program that is responsive to the preferences of patients with chronic diseases.
Showing items related by title, author, creator and subject.
Community health worker-delivered counselling for common mental disorders among chronic disease patients in South Africa: A feasibility studyMyers-Franchi, Bronwyn ; Petersen-Williams, P.; Van Der Westhuizen, C.; Lund, C.; Lombard, C.; Joska, J.A.; Levitt, N.S.; Butler, C.; Naledi, T.; Milligan, P.; Stein, D.J.; Sorsdahl, K. (2019)Objectives: To examine the feasibility and acceptability of integrating a 'designated' approach to community health worker (CHW)-delivered mental health counselling (where existing CHWs deliver counselling in addition to ...
Comparing dedicated and designated models of integrating mental health into chronic disease care: Study protocol for a cluster randomized controlled trialMyers-Franchi, Bronwyn ; Lund, C.; Lombard, C.; Joska, J.; Levitt, N.; Butler, C.; Cleary, S.; Naledi, T.; Milligan, P.; Stein, D.J.; Sorsdahl, K. (2018)Background: In low- and middle-income countries (LMIC), it is uncertain whether a "dedicated" approach to integrating mental health care (wherein a community health worker (CHW) has the sole responsibility of delivering ...
Protocol for development and validation of a context-appropriate tool for assessing organisational readiness for change in primary health clinics in South AfricaBrooke-Sumner, C.; Sorsdahl, K.; Lombard, C.; Petersen-Williams, P.; Myers-Franchi, Bronwyn (2018)Introduction A large treatment gap for common mental disorders (such as depression) exists in South Africa. Comorbidity with other chronic diseases, including HIV and diseases of lifestyle, is an increasing public health ...