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Integrating mental health into chronic care in South Africa: The development of a district mental healthcare plan
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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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“The following implementation strategies were reported: (i) engaging mental health stakeholders from inception to enhance their ownership and commitment, (ii) conducting sensitization workshops (37, 38), (iii) training clinical staff (36–38), (iv) supervising decision support and supporting staff well-being (3–37, 59), and leveraging available resources and existing systems (36–38).”
From Integration of Alcohol Use Disorder Interventions in General Health Care Settings in Sub-Saharan Africa: A Scoping Review (2022) · cites this paper as [38]
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“These strategies included methods to improve detection, support decision making, improve staff wellbeing, and ensure proper program management and supportive supervision (36–38).”
From Integration of Alcohol Use Disorder Interventions in General Health Care Settings in Sub-Saharan Africa: A Scoping Review (2022) · cites this paper as [38]
In the citing paper
“Some of these studies have further reported on implementation outcomes (e.g., feasibility or acceptability) of interventions for AUD in general health care settings (7, 36–38).”
From Integration of Alcohol Use Disorder Interventions in General Health Care Settings in Sub-Saharan Africa: A Scoping Review (2022) · cites this paper as [38]
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“In addition, these studies identified individual and structural bottlenecks for implementing integrated mental health services including AUD (36, 38).”
From Integration of Alcohol Use Disorder Interventions in General Health Care Settings in Sub-Saharan Africa: A Scoping Review (2022) · cites this paper as [38]
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“Additionally, these studies also identified various strategies that may facilitate the implementation of AUD components of an integrated mental health care program.”
From Integration of Alcohol Use Disorder Interventions in General Health Care Settings in Sub-Saharan Africa: A Scoping Review (2022) · cites this paper as [38]
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“In addition to that, we also found studies that reported frameworks and plans for integrated interventions for the mental health services that also included AUD care as one component.”
From Integration of Alcohol Use Disorder Interventions in General Health Care Settings in Sub-Saharan Africa: A Scoping Review (2022) · cites this paper as [38]
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“These studies demonstrated that AUD care, as a component of integrated mental health care, can achieve a positive and significant impact on clinical outcomes for people with AUD (36, 38).”
From Integration of Alcohol Use Disorder Interventions in General Health Care Settings in Sub-Saharan Africa: A Scoping Review (2022) · cites this paper as [38]
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Metadata
- Authors
- Petersen, I., Fairall, L., Bhana, A., Kathree, T., Selohilwe, O., Brooke-Sumner, C., Faris, G., Breuer, E., Sibanyoni, N., Lund, C., & Patel, V.
- Affiliations
- University of Cape Town (ZA)
- Corresponding author
- Petersen, Inge
- ORCID
- Venue
- British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 2016-01
- Volume
- 208
- Issue
- s56
- Pages
- s29-s39
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- PMC
- PMC4698554
- OpenAlex
- W2196257553
- Cited by
- 170
- References
- 41
- Citations by year
- 2026: 10 · 2025: 12 · 2024: 31 · 2023: 33 · 2022: 14 · 2021: 13 · 2020: 11 · 2019: 18 · 2018: 8 · 2017: 10 · 2016: 4
- FWCI
- 17.06
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- The British Journal of Psychiatry (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
- Funders
- Wellcome Trust (100714, 091834)
- Government of the United Kingdom
- Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
- Inyuvesi Yakwazulu-Natali
- University of Cape Town
- National Institute of Mental Health (R01MH100470)
- Topics
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Keywords
- mental health integration, chronic care, depression, alcoholism, schizophrenia, collaborative care, theory of change, health planning, implementation barriers, South Africa
- MeSH terms
- Mental Disorders, Community Mental Health Services, Health Workforce, Humans, Long-Term Care, Patient Care Planning, South Africa, Program Evaluation, Delivery of Health Care, Integrated, Qualitative Research
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