title: Integrating mental health into chronic care in South Africa: the development of a district mental healthcare plan.
abstract: 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.
  
  
  OBJECTIVE
  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.
  
  
  METHODS
  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.
authors.affiliation: Inge Petersen, PhD, School of Applied Human Sciences, University of KwaZulu-Natal, Durban, South Africa; Lara Fairall, PhD, Knowledge Translation Unit, University of Cape Town, Cape Town, South Africa; Arvin Bhana, PhD, Tasneem Kathree, MSocSci, One Selohilwe, MSocSci, Carrie Brooke-Sumner, MSc, School of Applied Human Sciences, University of KwaZulu-Natal, Durban, South Africa; Gill Faris, MPhil, Knowledge Translation Unit, University of Cape Town, Cape Town, South Africa; Erica Breuer, MPH, Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa; Nomvula Sibanyoni, MSocSci, National Department of Health, Pretoria, South Africa; Crick Lund, PhD, Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa, and Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; Vikram Patel, PhD, Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK and Centre for Mental Health, the Public Health Foundation of India, India peterseni@ukzn.ac.za.
authors.forename: Inge
authors.initials: I
authors.lastname: Petersen
authors.affiliation: Inge Petersen, PhD, School of Applied Human Sciences, University of KwaZulu-Natal, Durban, South Africa; Lara Fairall, PhD, Knowledge Translation Unit, University of Cape Town, Cape Town, South Africa; Arvin Bhana, PhD, Tasneem Kathree, MSocSci, One Selohilwe, MSocSci, Carrie Brooke-Sumner, MSc, School of Applied Human Sciences, University of KwaZulu-Natal, Durban, South Africa; Gill Faris, MPhil, Knowledge Translation Unit, University of Cape Town, Cape Town, South Africa; Erica Breuer, MPH, Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa; Nomvula Sibanyoni, MSocSci, National Department of Health, Pretoria, South Africa; Crick Lund, PhD, Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa, and Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; Vikram Patel, PhD, Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK and Centre for Mental Health, the Public Health Foundation of India, India.
authors.forename: Lara
authors.initials: L
authors.lastname: Fairall
authors.affiliation: Inge Petersen, PhD, School of Applied Human Sciences, University of KwaZulu-Natal, Durban, South Africa; Lara Fairall, PhD, Knowledge Translation Unit, University of Cape Town, Cape Town, South Africa; Arvin Bhana, PhD, Tasneem Kathree, MSocSci, One Selohilwe, MSocSci, Carrie Brooke-Sumner, MSc, School of Applied Human Sciences, University of KwaZulu-Natal, Durban, South Africa; Gill Faris, MPhil, Knowledge Translation Unit, University of Cape Town, Cape Town, South Africa; Erica Breuer, MPH, Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa; Nomvula Sibanyoni, MSocSci, National Department of Health, Pretoria, South Africa; Crick Lund, PhD, Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa, and Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; Vikram Patel, PhD, Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK and Centre for Mental Health, the Public Health Foundation of India, India.
authors.forename: Arvin
authors.initials: A
authors.lastname: Bhana
authors.affiliation: Inge Petersen, PhD, School of Applied Human Sciences, University of KwaZulu-Natal, Durban, South Africa; Lara Fairall, PhD, Knowledge Translation Unit, University of Cape Town, Cape Town, South Africa; Arvin Bhana, PhD, Tasneem Kathree, MSocSci, One Selohilwe, MSocSci, Carrie Brooke-Sumner, MSc, School of Applied Human Sciences, University of KwaZulu-Natal, Durban, South Africa; Gill Faris, MPhil, Knowledge Translation Unit, University of Cape Town, Cape Town, South Africa; Erica Breuer, MPH, Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa; Nomvula Sibanyoni, MSocSci, National Department of Health, Pretoria, South Africa; Crick Lund, PhD, Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa, and Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; Vikram Patel, PhD, Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK and Centre for Mental Health, the Public Health Foundation of India, India.
authors.forename: Tasneem
authors.initials: T
authors.lastname: Kathree
authors.affiliation: Inge Petersen, PhD, School of Applied Human Sciences, University of KwaZulu-Natal, Durban, South Africa; Lara Fairall, PhD, Knowledge Translation Unit, University of Cape Town, Cape Town, South Africa; Arvin Bhana, PhD, Tasneem Kathree, MSocSci, One Selohilwe, MSocSci, Carrie Brooke-Sumner, MSc, School of Applied Human Sciences, University of KwaZulu-Natal, Durban, South Africa; Gill Faris, MPhil, Knowledge Translation Unit, University of Cape Town, Cape Town, South Africa; Erica Breuer, MPH, Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa; Nomvula Sibanyoni, MSocSci, National Department of Health, Pretoria, South Africa; Crick Lund, PhD, Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa, and Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; Vikram Patel, PhD, Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK and Centre for Mental Health, the Public Health Foundation of India, India.
authors.forename: One
authors.initials: O
authors.lastname: Selohilwe
authors.affiliation: Inge Petersen, PhD, School of Applied Human Sciences, University of KwaZulu-Natal, Durban, South Africa; Lara Fairall, PhD, Knowledge Translation Unit, University of Cape Town, Cape Town, South Africa; Arvin Bhana, PhD, Tasneem Kathree, MSocSci, One Selohilwe, MSocSci, Carrie Brooke-Sumner, MSc, School of Applied Human Sciences, University of KwaZulu-Natal, Durban, South Africa; Gill Faris, MPhil, Knowledge Translation Unit, University of Cape Town, Cape Town, South Africa; Erica Breuer, MPH, Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa; Nomvula Sibanyoni, MSocSci, National Department of Health, Pretoria, South Africa; Crick Lund, PhD, Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa, and Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; Vikram Patel, PhD, Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK and Centre for Mental Health, the Public Health Foundation of India, India.
authors.forename: Carrie
authors.initials: C
authors.lastname: Brooke-Sumner
authors.affiliation: Inge Petersen, PhD, School of Applied Human Sciences, University of KwaZulu-Natal, Durban, South Africa; Lara Fairall, PhD, Knowledge Translation Unit, University of Cape Town, Cape Town, South Africa; Arvin Bhana, PhD, Tasneem Kathree, MSocSci, One Selohilwe, MSocSci, Carrie Brooke-Sumner, MSc, School of Applied Human Sciences, University of KwaZulu-Natal, Durban, South Africa; Gill Faris, MPhil, Knowledge Translation Unit, University of Cape Town, Cape Town, South Africa; Erica Breuer, MPH, Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa; Nomvula Sibanyoni, MSocSci, National Department of Health, Pretoria, South Africa; Crick Lund, PhD, Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa, and Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; Vikram Patel, PhD, Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK and Centre for Mental Health, the Public Health Foundation of India, India.
authors.forename: Gill
authors.initials: G
authors.lastname: Faris
authors.affiliation: Inge Petersen, PhD, School of Applied Human Sciences, University of KwaZulu-Natal, Durban, South Africa; Lara Fairall, PhD, Knowledge Translation Unit, University of Cape Town, Cape Town, South Africa; Arvin Bhana, PhD, Tasneem Kathree, MSocSci, One Selohilwe, MSocSci, Carrie Brooke-Sumner, MSc, School of Applied Human Sciences, University of KwaZulu-Natal, Durban, South Africa; Gill Faris, MPhil, Knowledge Translation Unit, University of Cape Town, Cape Town, South Africa; Erica Breuer, MPH, Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa; Nomvula Sibanyoni, MSocSci, National Department of Health, Pretoria, South Africa; Crick Lund, PhD, Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa, and Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; Vikram Patel, PhD, Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK and Centre for Mental Health, the Public Health Foundation of India, India.
authors.forename: Erica
authors.initials: E
authors.lastname: Breuer
authors.affiliation: Inge Petersen, PhD, School of Applied Human Sciences, University of KwaZulu-Natal, Durban, South Africa; Lara Fairall, PhD, Knowledge Translation Unit, University of Cape Town, Cape Town, South Africa; Arvin Bhana, PhD, Tasneem Kathree, MSocSci, One Selohilwe, MSocSci, Carrie Brooke-Sumner, MSc, School of Applied Human Sciences, University of KwaZulu-Natal, Durban, South Africa; Gill Faris, MPhil, Knowledge Translation Unit, University of Cape Town, Cape Town, South Africa; Erica Breuer, MPH, Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa; Nomvula Sibanyoni, MSocSci, National Department of Health, Pretoria, South Africa; Crick Lund, PhD, Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa, and Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; Vikram Patel, PhD, Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK and Centre for Mental Health, the Public Health Foundation of India, India.
authors.forename: Nomvula
authors.initials: N
authors.lastname: Sibanyoni
authors.affiliation: Inge Petersen, PhD, School of Applied Human Sciences, University of KwaZulu-Natal, Durban, South Africa; Lara Fairall, PhD, Knowledge Translation Unit, University of Cape Town, Cape Town, South Africa; Arvin Bhana, PhD, Tasneem Kathree, MSocSci, One Selohilwe, MSocSci, Carrie Brooke-Sumner, MSc, School of Applied Human Sciences, University of KwaZulu-Natal, Durban, South Africa; Gill Faris, MPhil, Knowledge Translation Unit, University of Cape Town, Cape Town, South Africa; Erica Breuer, MPH, Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa; Nomvula Sibanyoni, MSocSci, National Department of Health, Pretoria, South Africa; Crick Lund, PhD, Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa, and Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; Vikram Patel, PhD, Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK and Centre for Mental Health, the Public Health Foundation of India, India.
authors.forename: Crick
authors.initials: C
authors.lastname: Lund
authors.affiliation: Inge Petersen, PhD, School of Applied Human Sciences, University of KwaZulu-Natal, Durban, South Africa; Lara Fairall, PhD, Knowledge Translation Unit, University of Cape Town, Cape Town, South Africa; Arvin Bhana, PhD, Tasneem Kathree, MSocSci, One Selohilwe, MSocSci, Carrie Brooke-Sumner, MSc, School of Applied Human Sciences, University of KwaZulu-Natal, Durban, South Africa; Gill Faris, MPhil, Knowledge Translation Unit, University of Cape Town, Cape Town, South Africa; Erica Breuer, MPH, Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa; Nomvula Sibanyoni, MSocSci, National Department of Health, Pretoria, South Africa; Crick Lund, PhD, Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa, and Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; Vikram Patel, PhD, Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK and Centre for Mental Health, the Public Health Foundation of India, India.
authors.forename: Vikram
authors.initials: V
authors.lastname: Patel
mesh_terms: D003156:Community Mental Health Services / Q000458:organization & administration*; D019033:Delivery of Health Care, Integrated / Q000592:standards*; D006280:Health Workforce; D006801:Humans; D008134:Long-Term Care / Q000458:organization & administration*; D001523:Mental Disorders / Q000628:therapy*; D010347:Patient Care Planning / Q000592:standards*; D015397:Program Evaluation; D036301:Qualitative Research; D013019:South Africa