ABSTRACT:
Integrating mental health into HIV programmes could yield positive outcomes for People Living with HIV (PLWHIV) and contribute to the ambition to end AIDS globally by 2030, providing a comprehensive, person-centred approach to care(1-3). While the literature has demonstrated that PLWHIV are more likely to experience mental health issues compared with the general population(4-8), integrating mental health into HIV programmes has not been prioritised, resulting in missed opportunities for mental health. To this end, no opinions from policy developers regarding this integration have been explored in South Africa. Therefore, this study sought to document their opinions. A Strengths, Weaknesses, Opportunities and Threats (SWOT) analysis was conducted through Key Informant Interviews with sixteen policy developers, from Mental Health, HIV, Maternal, Children and Adolescents, and Primary Healthcare programmes in South Africa’s National Head Offices for health and social development. Thematic analysis was used to analyse data. Strengths: Availability of Policies, Service Delivery Platform (one-stop shop), Better Retention Outcomes, Monitoring and Evaluation Systems, Community Health Workforce, and Capacity Building of Healthcare Professionals. Weaknesses: Siloed Programmes; Lack of community engagement and empowerment; Lack of Awareness of the relationship between mental health and HIV; Lack of Integrated M&E Systems; Limited Health Workforce; Limited Capacity Building and Mentorship. Opportunities: Global guidance on integration; Scaling Community engagement and empowerment; Leveraging the Multisectoral approach; Funding alignment; Optimising Digitalisation; Optimising Peer Support and Advocacy; Leveraging Family support; Scaling Task shifting. Threats: Lack of funding; Treatment fatigue; Resistance to Change; Social Determinants of Health; Overburdened health workforce - facility congestion; Lack of political will; Minimal training for Psychiatric Health Professionals. Although opportunities to integrate mental health into HIV programmes and the strengths of this integration have been identified, however, the weaknesses indicate limited implementation. While the threats identified could hinder integration, leveraging its strengths and opportunities could make it attainable.