The feasibility of a Community Mental Health Education and Detection (CMED) tool in South Africa.

ABSTRACT

Background: Poor mental health literacy, misinformation about treatment and stigma result in low demand for mental health services in low-and middle-income countries. Community-based interventions that raise mental health awareness and facilitate detection of mental health conditions, are instrumental in increasing demand through strengthened mental health literacy, as well as supply of available mental health services through strengthened detection and linkage to care. Objective: To assess the feasibility of a Community Mental Health Education and Detection Tool (CMED) for use with household members by community health teams in South Africa. Methods: The feasibility of using the CMED in households was assessed using Bowen et al.'s framework which informed the study design, interview tools and analysis. The feasibility study involved four phases (1) observations of the CMED consultation to evaluate the administration of the tool; (2) semi-structured interviews with household member/s after the CMED was administered to explore experiences of the visit; (3) follow-up interviews of household members referred using the CMED tool to assess uptake of referrals; (4) and weekly focus group discussions with the community health team to explore experiences of using the tool. Framework analysis was used to inform a priori themes and allow inductive themes to emerge from the data. Results: The CMED was found to be acceptable by both community health teams and household members, demand for the tool was evident, implementation, practicality and integration within the existing health system were also indicated. Conclusion: The CMED is perceived as feasible by household members and community health teams, suggesting a 'goodness of fit" within the existing health system.