Knowledge deficits influencing the early detection of mental health disorders by registered nurses in Primary Health Care settings in Tshwane District

Abstract

Registered nurses are the first healthcare professionals encountered by most patients accessing primary health care (PHC) services and therefore play a critical role in recognising early signs of mental health disorders. Early identification is essential for timely intervention, improved treatment outcomes, and reducing the burden associated with mental illness. However, the ability of registered nurses to detect mental health disorders early may be limited by knowledge deficits, particularly in resource-constrained PHC settings such as the Tshwane District. This study explored and quantified how knowledge deficits influence the early detection of mental health disorders by registered nurses in PHC settings in the Tshwane District. A convergent parallel mixed-methods design was adopted, whereby quantitative and qualitative data were collected simultaneously, analysed separately, and integrated during interpretation. Data were collected from registered nurses working in selected PHC facilities using structured questionnaires and semi-structured interviews. Quantitative data were analysed using descriptive and inferential statistics, while qualitative data were analysed through thematic analysis. The findings showed that knowledge deficits remain an important barrier to the early detection of mental health disorders. Quantitative findings revealed low levels of confidence among registered nurses in identifying mental health conditions and limited use of standardised mental health screening tools during routine consultations. Qualitative findings further demonstrated that insufficient and outdated knowledge, limited practical assessment skills, challenges with communication and interviewing techniques, language barriers, and attitudes towards mental health affected nurses’ ability to recognise mental health concerns early. These challenges may contribute to delayed identification and missed opportunities for timely referral and intervention at the Primary Health Care PHC level.
The study concludes that strengthening the mental health knowledge and competencies of registered nurses is essential to improve early detection practices in PHC settings. Investment in targeted training programmes, ongoing professional development, and supportive health system structures may strengthen nurses’ capacity to provide timely and responsive mental healthcare.