Abstract:
BACKGROUND : Additional human resources are needed to provide mental health services in
underserved areas in South Africa (SA). Clinical associates, the mid-level medical worker
cadre in SA, could potentially be used to deliver these services.
AIM : The study explored the self-reported knowledge, confidence, and current practices of
clinical associates related to mental health assessment and management.
SETTING : South Africa.
METHODS : A cross-sectional study was conducted. The link to the electronic questionnaire
was distributed to clinical associates via databases and social media. Data were analysed with
Stata v17.
RESULTS : Of the 209 participants, 205 (98.1%) indicated they had training on management of
patients with mental illness during their undergraduate degree and 192 (91.9%) had a mental
health rotation. Few (10.7%) had any additional mental health training. Most participants
rated their knowledge of priority mental disorders as ‘good’ or ‘excellent’. Only 43.2% of the
participants felt quite or very confident to perform a mental health examination. Participants
who felt quite or very confident to manage patients presenting with suicide risk, aggression,
and confusion were 44.9%, 46.9% and 53.1%, respectively. Factors associated with a confidence
score of 75% and higher were male gendered, working in Gauteng or Northern Cape provinces,
and in a rural area. The majority of participants were already involved in mental health
assessment and management in their current work.
CONCLUSION : Clinical associates have a contribution to make in mental health service provision,
but this may need to be supplemented by additional practical training.
CONTRIBUTION : Potential gaps in training have been identified.
