The perceived feasibility and acceptability of integrating depression management in non-communicable diseases clinics in Malawi

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Abstract Background Integration of mental health into other health care services is one way of reducing the treatment gap and increasing access to mental health care. Aim This study was conducted to explore the perceptions of health workers about the perceived feasibility and acceptability of integrating depression management into diabetes clinics. Methods This qualitative study used a descriptive exploratory design; it is the second phase of a mixed methods study aimed at evaluating the effect of integrating depression management into non-communicable diseases (NCD) routine care on patient and service outcomes in Malawi. We conducted in-depth interviews with 8 healthcare workers who provide diabetes care within NCD clinics in three districts in the central region of Malawi. Informed consent was obtained from all participants. An interview guide was used to guide enquiry about perceptions of feasibility and acceptability of integrating depression screening and management. Interviews were transcribed and analysed using deductive and inductive coding in NVivo 12 software. Results Depression was acknowledged as a common mental health problem that affects many patients attending NCD clinics. The chronic nature of the diseases seen in the NCD clinics was identified as the cause of depression. All study participants acknowledged the need to screen for and manage depression at the NCD clinics. Additionally, they viewed training and expanding the healthcare workforce involved in NCD care as crucial to effectively integrating depression screening and management in NCD care. Conclusion This study demonstrated the acceptability to health workers of integrating depression screening and management in NCD clinics in Malawi. It also highlights the importance of building capacity of NCD healthcare workers in depression screening and management through training and workforce expansion.

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