Factors impeding ability of health care providers from detecting mental health related problems at primary health care level in Lusaka

Abstract

Introduction: Mental health problems such as stress related conditions, substance abuse related problems, lead to difficulties in social, occupational and marital problems. Failure to detect mental health problems denies patients potentially effective management. The objective of the study was to explore factors impeding health care providers to detect mental health problems at PHC level in Lusaka. Methods: This was a mixed method study involving primary health care providers. The study used simple random and purposive sampling methods. Quantitative and qualitative data was collected using a structured interview schedule and focus group discussion guide respectively. Quantitative data was analyzed using SPSS version 20 software computer packages. Qualitative data was analyzed using content analysis. Chi-square test was used for evaluation of data, with the confidence interval set at 95%, and the P value was equal or less than 0.05. Results: A total of 134 participants took part in the structured interview and 20 in the FGD. Participants’ age ranged from 25 – 55 years with a mean age of 43. One hundred and five (78.4%) were females with a profession ratio of 1:4 (Clinical officer and Nurses). A total of 58(100%) of the participants had high knowledge level in mental health and were able to use the mental health standardized guidelines, 41(53.4%) had low knowledge level and 39(51.3%) were unable to use the guidelines. Chi–square results on knowledge in mental health and use of mental health standardized guidelines showed a statistically significant relationship with p-value = 0.000, X2 = 45.968 and p-value = 0.000, X2 = 41.982 respectively. FGD revealed that health care providers have inadequate knowledge in mental health, have high work-load, have reduced patient contact time 5 – 10 minutes and no available standardized guidelines in mental health. Conclusion: There is low ability to detect mental health problems. Knowledge level and use of mental health standardized guidelines are some of the factors impeding the ability of health care providers to detect mental problems early. Primary health care providers need regular in-service training in mental health and should use standardized guidelines to detect mental health early