**11. Recommended primary health care mental health services**

A functional primary health care system should provide adequate services for most patients, so that only a selected few of these need referrals to higher levels of care. For that reason, primary healthcare services should be able to provide the following comprehensive mental health services:

#### **11.1 Screening**

The purpose of screening is for early detection, which is essential for both substance abuse and mental disorders, because if left unattended, these conditions tend to worsen and complicate, with poor treatment outcomes. Screening is therefore essential as it can assist with the early identification of both substance-related problems and mental illness, and guide the provision of appropriate services [53].

One of the key examples of failure to screen for pregnant mothers is the Fetal Alcohol Spectrum Disorders, which are often only detected after the child is born [54]. Specifically, the continuous neglect of screening for maternal depression has major negative implications for the children of such mothers, to the extent that the children's constitutional rights are violated [55].

#### **11.2 Prevention of mental illness and promotion of mental health**

Both the prevention of mental illness and active promotion of mental health interventions are public health interventions for holistic approach for positive health outcomes [56]. This requires the identification of associated risk factors, and act on them. Because key contributors to mental illness are mostly socially derived, the negative social factors operational in communities need to be considered as points of attention. Prevention of mental illness and promotion of mental health has an economic value [57], hence the need to put efforts for their promotion.

#### **11.3 Treatment**

Although a few PHC clinics offer some mental services, the quality of treatment received does not meet the recommended mental health guidelines, and is therefore compromised [58]. In particular, promotion of mental health is often missing. Within the re-engineered primary health care package, which includes the utilization of a well-resourced district-based specialist teams, primary health care services will be enhanced to offer quality and effective treatment. However, not all clinics have functional district-based specialist teams, which needs to be improved.

With political commitment and following the spirit of the National Development plan and the core principles of Primary Health care, PHC services in South Africa can be an effective strategy in achieving the goal of health for all, including mental health services. This also applies to other African countries, which can use this strategy to coordinated efforts to achieve the health care components of the SDGs [9].

#### **11.4 Ongoing support**

A key success indicator for the treatment of chronic mental illness is the ability of the health system to provide ongoing support. This is necessitated to counteract possible relapse, which is common as the patients often experience treatment fatigue. Patients with chronic mental illness also often move residence, due to various social problems, which exposes them to discontinuity of treatment [59].

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

In the absence of any efforts for ongoing support, they are often lost to follow-up, with negative outcomes. In the South African setting, the existence of the Ward based PHC outreach teams can be effectively utilized for this service.
