Patient preferences for the integration of mental health counseling and chronic disease care in South Africa

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 3...

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Main Authors: Myers-Franchi, Bronwyn, Joska, J.A., Lund, C., Levitt, N.S., Butler, C.C., Naledi, T., Milligan, P., Stein, D.J., Sorsdahl, K.
Format: Journal Article
Language:English
Published: DOVE MEDICAL PRESS LTD 2018
Subjects:
Online Access:http://hdl.handle.net/20.500.11937/85657
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author Myers-Franchi, Bronwyn
Joska, J.A.
Lund, C.
Levitt, N.S.
Butler, C.C.
Naledi, T.
Milligan, P.
Stein, D.J.
Sorsdahl, K.
author_facet Myers-Franchi, Bronwyn
Joska, J.A.
Lund, C.
Levitt, N.S.
Butler, C.C.
Naledi, T.
Milligan, P.
Stein, D.J.
Sorsdahl, K.
author_sort Myers-Franchi, Bronwyn
building Curtin Institutional Repository
collection Online Access
description 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.
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spelling curtin-20.500.11937-856572021-10-07T03:51:04Z Patient preferences for the integration of mental health counseling and chronic disease care in South Africa Myers-Franchi, Bronwyn Joska, J.A. Lund, C. Levitt, N.S. Butler, C.C. Naledi, T. Milligan, P. Stein, D.J. Sorsdahl, K. Science & Technology Life Sciences & Biomedicine Medicine, General & Internal General & Internal Medicine integration mental health chronic disease care counseling preferences primary health care South Africa global mental health task sharing alcohol depression MIDDLE-INCOME COUNTRIES HUMAN-IMMUNODEFICIENCY-VIRUS RANDOMIZED CONTROLLED-TRIAL PROBLEM-SOLVING THERAPY SUBSTANCE USE WESTERN CAPE INTERVENTION SERVICES DISORDERS PERSPECTIVES 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. 2018 Journal Article http://hdl.handle.net/20.500.11937/85657 10.2147/PPA.S176356 English http://creativecommons.org/licenses/by/4.0/ DOVE MEDICAL PRESS LTD fulltext
spellingShingle Science & Technology
Life Sciences & Biomedicine
Medicine, General & Internal
General & Internal Medicine
integration
mental health
chronic disease care
counseling preferences
primary health care
South Africa
global mental health
task sharing
alcohol
depression
MIDDLE-INCOME COUNTRIES
HUMAN-IMMUNODEFICIENCY-VIRUS
RANDOMIZED CONTROLLED-TRIAL
PROBLEM-SOLVING THERAPY
SUBSTANCE USE
WESTERN CAPE
INTERVENTION
SERVICES
DISORDERS
PERSPECTIVES
Myers-Franchi, Bronwyn
Joska, J.A.
Lund, C.
Levitt, N.S.
Butler, C.C.
Naledi, T.
Milligan, P.
Stein, D.J.
Sorsdahl, K.
Patient preferences for the integration of mental health counseling and chronic disease care in South Africa
title Patient preferences for the integration of mental health counseling and chronic disease care in South Africa
title_full Patient preferences for the integration of mental health counseling and chronic disease care in South Africa
title_fullStr Patient preferences for the integration of mental health counseling and chronic disease care in South Africa
title_full_unstemmed Patient preferences for the integration of mental health counseling and chronic disease care in South Africa
title_short Patient preferences for the integration of mental health counseling and chronic disease care in South Africa
title_sort patient preferences for the integration of mental health counseling and chronic disease care in south africa
topic Science & Technology
Life Sciences & Biomedicine
Medicine, General & Internal
General & Internal Medicine
integration
mental health
chronic disease care
counseling preferences
primary health care
South Africa
global mental health
task sharing
alcohol
depression
MIDDLE-INCOME COUNTRIES
HUMAN-IMMUNODEFICIENCY-VIRUS
RANDOMIZED CONTROLLED-TRIAL
PROBLEM-SOLVING THERAPY
SUBSTANCE USE
WESTERN CAPE
INTERVENTION
SERVICES
DISORDERS
PERSPECTIVES
url http://hdl.handle.net/20.500.11937/85657