# Patient and Healthcare Worker Perspectives on the Integration of Mental Health Services Into Routine ART Services in Windhoek, Namibia: A Qualitative Study

## TL;DR

This study explores how mental health services can be better integrated into HIV treatment in Namibia by examining the views of patients and healthcare workers.

## Contribution

The study provides insights into local barriers and enablers for integrating mental health services into ART services in Namibia.

## Key findings

- Barriers include lack of awareness, staff shortages, and limited resources.
- Enablers include training, policy integration, and community awareness.

## Abstract

Mental health illnesses are more common in people living with HIV (PLHIV) than in the general population, and mental health issues can make it more difficult for individuals to stay engaged in HIV care, which can negatively affect treatment outcomes. Therefore, integrating mental health services into routine HIV care can improve treatment outcomes for PLHIV. This study assessed patients’ and healthcare workers’ perceptions of enablers and barriers to integrating mental health interventions in routine Antiretroviral treatment (ART) services in Windhoek, Namibia.

In-depth interviews were conducted to explore the perspectives of PLHIV, healthcare providers providing ART services, and health managers supporting the national HIV program on integrated mental health services. To assist with data organization, data analysis software (NVivo V.12) was used. Colaizzi’s (1978) inductive thematic analysis was then applied to explore key concepts.

The Barriers reported were the lack of awareness of mental illnesses among PLHIV, healthcare worker attitudes, limited physical space at health facilities, insufficient financial resources to address staff shortages, and lack of training for healthcare workers. The enablers reported were integrated screening of mental illnesses, training of Healthcare workers, management support, integration policies and guidelines, and community sensitization and awareness on mental health issues.