**6. The appropriateness of primary health care services for mental health services**

The advantages of the PHC as appropriate for the delivery of health services are many, including that most of such facilities are in communities and many clients are within walking distance to the nearest clinic. However, the availability of a structure does not necessarily guarantee optimal health services, as some of the clinics fall short of providing intended basic services. This implies that there is a need to continuously assess the functionality of primary health care services, to determine their relevance and effectiveness in providing services that are determined by community needs and priorities. An example of this gap is the increase in substance abuse and mental health challenges that have been prevalent in the last few years, and the failure of the health system to respond to the needs in the context of related services. As with other African countries, the South African Primary health care (PHC) nurse led [25], which is confirmed by the proportion of nurses compared to other health professionals, and the services rendered at PHC levels. It is for that reason that government can afford to offer services at no cost to the client as the State bears such costs [26].

What substance abuse and mental health have in common is that both are significantly impacted upon by social issues, which means that failure to respond appropriately may subject more members of the affected communities to similar

*The Need to Strengthen Primary Health Care Services to Improve Mental Health Care Services… DOI: http://dx.doi.org/10.5772/intechopen.99781*

challenges, which just increases the community burden of substance abuse and mental disorders. The increasing prevalence in both substance abuse and mental disorders has been well documented, but there is silence on how the PHC system has been prepared to respond in the appropriate manner. On the contrary, there is inequitable access to substance abuse treatment services in South Africa, and that, even among those that have access, the quality of services is often not ascertained. This is demonstrated by the action of government limiting itself to ensuring access but not putting adequate efforts to ensure quality that will improve treatment outcomes [27, 28]. The strengthening of PHC services in the area of mental health will thus increase access to the benefit of those that lacked such access. The monitoring of substance abuse services at PHC level, which is essential for making decisions, is not optimal [29].
