Browsing by Author "Sibeko, Ntokozo"

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    Evaluating the effectiveness of mental health training on the knowledge and attitudes of non-specialist health workers in South Africa
    (2025) Mahlakametsa, Mpho; Sibeko, Ntokozo
    Mental disorders have a considerable impact on the rates of disability in the world. Economic data have consistently shown that the indirect losses resulting from poorly managed mental disorders continue to outstrip countries' health budgets. Given a significant shortage of health care professionals in low-and middle-income countries, particularly for mental health, and the unequal distribution of resources, a task-shifting approach has been proposed to broaden access to services using less specialised health care providers and reduce the treatment gap resulting from a shortage of human resources. The study observations have shown that this as a feasible option that may improve mental health outcomes. This study expanded on a pilot intervention study carried out by Sibeko and colleagues, which demonstrated that mental health training offered to non-specialised health workers' (NSHW) in the Western Cape province of South Africa had a positive impact on their knowledge, confidence, and attitudes. Method: This study analysed data collected as part of routine programmatic data collection of mental health training provided to 344 NSHW in various centres across South Africa. The mental health knowledge schedule and community attitudes towards mental illness tests were administered before and after the training was provided. The test scores were analysed using regression models to determine which of the demographic characteristics had an impact in the scores. Results: Seventy one percent of the training recipients were women, with 97% of them with a minimum education level of grade 8 or higher. The median age was 36, with the median duration of working as a NSHW of six years. There was an overall statistically significant increase in the knowledge score (pre-training median 43, post-training median 46, p-value < 0.01). nearly 90% recipients showed an openness to living next to individuals with mental illness. Following training, the recipients were less likely to report that people suffering from mental disorders were threatening. There only statistically significant change in attitude scores was in the social restrictiveness subscale (pre-training median 28, post-training median, 27 p-value <0.01). Conclusion: The training provided to the NSHW improved their knowledge and attitude scores, in keeping with the original study. We recommend continued training to upskill this cadre of health workers to enhance the screening, early recognition of, and intervention of mental disorders.
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    Open Access
    High levels of stigma towards substance use and depression amongst non-specialist health workers in South Africa
    (2023) Goncalves, Richard; Sibeko, Ntokozo; Myers Bronwyn
    As mental health-related stigma is a significant barrier to seeking and receiving healthcare, stigma amongst non-specialist health workers (NSHWs) towards patients with major depressive disorder (MDD) and substance use disorder (SUD) could negatively affect mental health service provision. This study aimed to explore (1) the level of stigma towards MDD and SUD among NSHWs employed in primary care settings in South Africa, (2) the extent to which socio-demographic factors might be associated with stigma levels amongst these NSHWs, and (3) NSHWs' interest in receiving training for MDD or SUD. Overall, 81 NSHWs completed a culturally modified version of the Social Distance Scale (SDS) that assessed stigma towards a hypothetical patient with MDD and a hypothetical patient with SUD; higher cumulative SDS scores represented greater stigma. With a possible range of 6-24, we found a mean SDS score of 9.0 (SD=3.7) for MDD and 11.7 (SD=4.4) for SUD. Results show elevated levels of stigma towards both hypothetical patients, with significantly higher mean SDS scores for SUD compared to MDD (p <0.001). No socio-demographic variables were significantly associated with MDD or SUD stigma levels. When asked to rate their interest, more NSHWs were “very interested” in receiving training for MDD (90.0%) than for SUD (80.8%); this difference was statistically significant (p=0.027). High levels of self-reported stigma, coupled with a desire for further training, suggest that it would be prudent to incorporate stigma reduction measures into future MDD and SUD training programmes for NSHWs.
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    The prevalence of psychoactive substance use amongst undergraduate students at a medical school in South Africa
    (2025) Nair, Devina; Dannatt, Lisa; Sibeko, Ntokozo
    Background: Substance use and its associated problems are a global public health concern. Factors that can influence trends in substance use include the characteristics of the substance itself as well as those related to the individual and their environment (including availability and implementation of national and local policy and service delivery). Students entering a tertiary education facility show a marked increase in substance use compared to those that live at home or seek employment following graduation from high school. Several risk factors for substance use are specific to this population, including an affiliation with fraternity or sorority life, perception of high academic pressure and peer pressure. Substance use disorders develop over time following repeated episodes of misuse. It may therefore be possible to identify emerging risky substance use and to potentially arrest the development of more problematic substance use and addiction. Aim: To determine the prevalence of substance use in a sample of undergraduate students at a medical school in South Africa. Methods: This was a descriptive cross-sectional study conducted at the University of Cape Town's (UCT) medical campus. The study population included all undergraduate medical students in years one through to six who consented to participate. As this was a descriptive study no set recommendations were given regarding appropriate sample size. Data was collected using an online version of the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). This tool was developed as a Web App version for this study by the UCT Department of Psychiatry and Mental Health and allowed for completion of an auto-scoring version of the ASSIST. To maintain anonymity the system assigned a random identity token which was not linked to any identifying data. Screening risk scores and brief intervention outcomes, including information for inward referral for assessment and care, were shared with the participant onscreen at the end of the screening process. The anonymized data was analysed using the R statistical software package. Descriptive statistics was used to summarize the data. Results: 444 ASSIST tools were completed with signed consent and therefore appropriate for the data analysis; this equated to a response rate of 32,2%. Across all demographics, 83.1% (369 respondents) reported substance use. Alcohol (88,1%) followed by cannabis (53,8%) and tobacco (43,1%) were the most commonly used substances by our student population. Overall, our study found that the prevalence of substance use at UCT medical school is higher in females, Caucasian individuals and students in the later years of study. The vast majority of the students, 359 out of 369 (97,3%), fall into the low-risk category for substance use. Conclusion: From this study we see that the prevalence of substance use amongst undergraduate medical students at UCT is high (83,1%). However, in this study calculated risk was shown to be low. Whilst risk might be low, we know that substance use disorders develop over time with repeated episodes of misuse. Given the devastating sequelae of substance use disorders, early identification, primary prevention and intervention is needed. Further studies building on this one would be useful particularly in exploring cause and effect of substance use. It would be interesting to see whether, as seen in international literature, difficulty in social integration as well as academic pressure from increased work load could be contributing to the high prevalence of substance use that we have seen in this population. These findings might assist in streamlining and optimising the support services that the university is able to offer this student group.