How to design education on mental disorder for general practitioners in South Africa

Abstract

Objective: This study looks at how the WHO programme Mental Disorders in Primary Care should be adapted for GPs in the South African context in order to positively impact the recognition and management of mental disorders. Design: Participatory action research was used to adapt the WHO programme. There were 3 phases to the study. Firstly a co-operative inquiry group of 10 GPs adapted the WHO materials. Secondly the findings of the inquiry were incorporated into the design of a web-based distance education programme.Thirdly the web-based programme was evaluated by means of an action inquiry with the 21 registered GPs. Setting: South African general practitioners working in both public and private practice. Results: The findings of the study are presented as a model of the primary care consultation with a specific focus on the recognition and management of mental disorders. The approach includes the use of one hypothesis for 'mental problems' and assessment in the 'lobby' of general practice. Six governing variables for this approach are described: cues, communication skills, continuity of care, confidence, course tools and community resources. Conclusion: This study presents a practical model of the primary care consultation, which focuses on an approach to the recognition and management of mental disorders. This model has been used to adapt the WHO programme for the South African context. The model may be of use to general practitioners, educational designers, teachers of family medicine / primary care as well as district managers who wish to enhance the quality of care for patients with mental disorders.