Views held by South African primary health care nurses on caring for people living with mental illness

Abstract

Background: Primary healthcare is the first point of entry into the healthcare system. Scaling up primary mental healthcare is recommended in South African mental health policy. However, there is a paucity of data exploring the views of primary healthcare nurses (PHCNs) with regards to caring for people living with mental illness (PLWMI) in South Africa.

Aim: To explore the views of PHCNs around caring for PLWMI and task shifting.

Setting: A community health centre in Gauteng province, South Africa.

Methods: A qualitative study design using the framework approach was employed. Semi-structured individual interviews were conducted among a convenient sample of PHCNs in a community health centre in Gauteng. Interviews were transcribed and data analysed thematically.

Results: Eight PHCNs were interviewed in June 2022. Five themes emerged: (1) participants highlighted their current practice which excludes mental healthcare; (2) participants described feeling fearful of caring for PLWMI; (3) participants ascribed their lack of confidence in caring for PLWMI largely due to insufficient under- and post-graduate mental healthcare training. (4) task shifting was not welcome due to inadequate mental healthcare training and preexisting challenges in the healthcare system; and (5) recommendations to prioritise mental healthcare training prior to implementing task shifting were made.

Conclusion: Primary healthcare nurses, although empathic towards PLWMI, expressed discomfort with caring for them. This is influenced by multiple factors, some of which may be addressed by improved training and support.

Contribution: This study provides insight into how PHCNs feel about caring for PLWMI and task shifting.