Healthcare worker perspectives on barriers to integrating mental health services into human immunodeficiency virus care in Windhoek, Namibia: A convergent parallel mixed-methods design

Abstract

Background: Mental illnesses are more prevalent in people living with HIV (PLHIV) than in the general population, highlighting the need to integrate mental health services into primary healthcare (PHC). Health workers are key players in integrating these services.
Aim: This study assessed healthcare workers’ perceptions, opinions, and experiences on barriers to integrating mental health services into antiretroviral therapy (ART) services.
Setting: The study was conducted in public health facilities in Windhoek, Namibia.
Methods: A descriptive mixed-methods study using a convergent parallel design was conducted among 44 healthcare workers (n = 44), including 10 in-depth interviews. Data were collected through questionnaires and in-depth interviews. Quantitative data were analysed using STATA version 15, while qualitative data were analysed using NVivo 12.
Results: The study identified several barriers, including inadequate facility space, limited knowledge and skills for managing mental illness, insufficient in-service training, a lack of guidelines and standard operating procedures, and staff shortages.
Conclusion: Significant structural and workforce-related barriers hinder effective mental health screening, diagnosis, and treatment for PLHIV in PHC settings. Addressing these challenges requires facility restructuring, workforce training, task shifting, and strong political commitment to strengthen healthcare infrastructure.
Contribution: The study provides valuable insights into healthcare workers’ experiences and contributes much-needed regional evidence on barriers to integrating mental health services into HIV care in Namibia.