MhINT: Mental Health Integration into Primary Care

Outline:

MhiNT (Mental Health Integration Programme): Strengthening the Evidence Base and Capacity for Implementing HIV Prevention.

In the context of the re‐engineered PHC system, including integrated chronic care in South Africa, the University of KwaZulu-Natal is collaborating with the University of Washington, I‐TECH South Africa, University of Cape Town’s Knowledge Translation unit and the national and provincial DOH in North West, Mpumalanga and KwaZulu-Natal to scale up the evidence-based PRIME collaborative care model in four districts. (Read more here.)

The MhINT programme aims to facilitate the integration of mental health services in PHCs through a task-sharing approach that strengthens detection of common mental health disorders (i.e. depression and anxiety) and provides a referral pathway for patients within the PHC system. It is necessitated by the prevalence of common mental health disorders in the PHC population with adverse implications for treatment adherence in patients with chronic conditions.

As part of the intervention MhINT provides the following training and technical support:

  • Our APC Master Trainers provide clinicians with training on screening and assessing for mental disorders commonly found in PHC using the Adult Primary Care Guidelines (PC101/ APC).
  • Our MhINT Trainer Supervisors train district level registered psychological counsellors on how to train lay-counsellors to provide a structured psychosocial counselling intervention to patients with identified common mental disorders at PHC. The lay-counsellors are also trained to provide adherence counselling for patients with chronic conditions.
  • The MhINT Programme Manager and coordinator train available district based mental health specialists (psychologists/ advanced psychiatric nurses/ registered counsellors) so that they are equipped with skills to train and support lay-counsellors and clinicians in implementing the mental health programme. This is essential for ensuring that the skills provided by the programme are not lost but remain in the district.
  • The MhiNT CQI mentor and Advisors provide training in Continuous quality improvement to different caders at DOH Provincial, District, sub-district and facility level in order to equip them with skills to monitor and track the implementation of the mental health programme and improve on their performance on identified mental health indicators.
  • The MhINT programme provides continued support and mentorship to the implementation sites through the office of the District Mental Health Coordinator as well as in collaboration with the Provincial Mental Health Directorates. We also work closely with the Provincial Mental health Directorates to share lessons from implementation that can assist in scaling up the MhINT intervention to the rest of the province and ultimately, the rest of the country.

Progress:

Training:

  • In the left corner wearing green pants: Ms Nozipho Mpontshane (MhINT Trainer-Supervisor) pictured with the Registered Counsellors (Ms Gugu Mashego) and Clinical Psychologist (Mr Wandile Ndala) from Nkomazi Sub-district in Mpumalanga Province.

    The picture is taken at the end of the Depression and Adherence counselling training for the 2nd group of Lay-counsellors in Nkomazi sub-district on 7 November 2018

  • Taken on 18 March 2019 in George

    Ms Nozipho Mpontshane (MhiNT Trainer-Supervisor) and Ms Estelle Crause (Eden District Outreach Clinical Psychologist) after providing training to Behavior Change counsellors in the Depression and Adherence counselling in Eden District.

  • 18 August 2018 Ms Nozipho Mpontshane (MhiNT Trainer Supervisor) with the first group of Lay counsellors trained in the Nkomazi sub-district, Mpumalanga Province. e Depression and Adherence counselling in Eden District.

  • Ms Rethabile Khadikane Ms Nozipho Mpontshana (MhINT Trainer-Supervisors), Ms Gugu Gigaba (MhiNT Programme Manager) with the Amajuba Principal Psychologist (Ms Ziningi Mchunu) and Amajuba District Training Coordinator (Ms Nomathemba Mazibuko) with the lay counsellors from the Danhauser sub-district of Amajuba District, KwaZulu-Natal.

    The picture was taken on the 20th of September 2018 after the Depression and Adherence counselling training

  • Taken on 22 November 2018 in Newcastle at the end of the Psychologists MhINT Master Trainer Training.

    From left to right: Ms Gugu Gigaba (MhINT Programme Manager), Ms Estelle Crause (Eden District Clinical Psychologist), Ms Mandisa Nxele (Amajuba District Clinical Psychologist), Dr. Gillian Douglas (King Cetshwayo Outreach Clinical Psychologist), Ms Ziningi Mchunu (Amajuba district Principal Psychologist) and Ms Gillian Faris (Adult Education Specialist – MhiNT Consultant).

  • Picture taken on 30 August 2018 during a workshop to revise the MhINT Depression and Adherence counselling manuals and train the Registered Counsellors
    From left to right: Ms Nozipho Mpontshane (MhiNT Trainer supervisor), Ms Gugu Mashego (Registered Counsellor Nkomazi sub-district), Ms Gillian Faris (Adult Education Specialist: MhINT consultant), Ms Gugu Gigaba (MhiINT Programme Manager) and Ms Rethabile Khadikane (MhiNT Trainer-Supervisor)

MhINT manuals:

  • MhINT operations Manual
  • Master Trainer Manual for Psychologists
  • Registered Psychological Counsellors Manual
  • Lay Counsellor Depression and Adherence counselling manual

To request these resources please send an email to Peterseni@ukzn.ac.za.

Project News

The Mental Health Integration Programme (MhINT) and the Southern African Research Consortium for Mental health INTegration (S-MhINT) teams, led through the CRH, created a video which addresses anxieties healthcare workers may face in the wake of COVID-19. Click HERE to read an article published in the UKZNDabaOnline about the video. 

Click HERE to visit the CRH’s data-free COVID-19 hub.