Nurses’ implementation of mental health screening among HIV infected guidelines

Up to 25% of people living with HIV (PLWHA) in South Africa are thought to suffer from some form of depression and anxiety during the course of the illness. The nurse-initiated ART improves patients’ access to ART and gives nurses authority to treat uncomplicated patients. However, there is no parallel continuing development program aimed at preparing nurses to manage mental health problems at primary health care level. The purpose of the study was to explore nurses’ interpretation and implementation of HIV/AIDS guidelines for mental health screening among HIV-infected individuals in South Africa.A qualitative, exploratory and descriptive approach was employed, using purposive sampling to select primary health professional nurses trained in HIV programmes at five primary health care facilities. Data were collected through focus groups and in-depth individual interviews. Thematic analysis was used to generate three themes, namely; guidelines as framework for care pathway, mental screening practices, strengthening mental health screening. The study revealed significant weakness in the detection of mental illness in primary health care settings, due to a lack of skills and insufficient screening resources. The implication of these findings is a need to equip all NIMART trained nurses with basic mental health screening skills.