TY - JOUR Y1 - 2015/09// TI - Supporting mental health in South African HIV-affected communities: primary health care professionals' understandings and responses VL - 30 KW - HIV KW - practitioner understandings KW - primary mental health care KW - South Africa KW - women?s mental health A1 - Burgess, RA EP - 927 IS - 7 UR - https://doi.org/10.1093/heapol/czu092 ID - discovery10072482 N1 - This version is the author accepted manuscript. For information on re-use, please refer to the publisher?s terms and conditions. JF - Health Policy and Planning PB - OXFORD UNIV PRESS N2 - How do practitioners respond to the mental distress of HIV-affected women and communities? And do their understandings of patients? distress matter? The World Health Organization (WHO) along with advocates from the Movement for Global Mental Health (MGMH) champion a primary mental health care model to address burgeoning mental health needs in resource-poor HIV-affected settings. Whilst a minority of studies have begun to explore interventions to target this group of women, there is a dearth of studies that explore the broader contexts that will likely shape service outcomes, such as health sector dynamics and competing definitions of mental ill-health. This study reports on an in-depth case study of primary mental health services in a rural HIV-affected community in Northern KwaZulu-Natal. Health professionals identified as the frontline staff working within the primary mental health care model (n = 14) were interviewed. Grounded thematic analysis of interview data highlighted that practitioners employed a critical and socially anchored framework for understanding their patients? needs. Poverty, gender and family relationships were identified as intersecting factors driving HIV-affected patients? mental distress. In a divergence from existing evidence, practitioner efforts to act on their understandings of patient needs prioritized social responses over biomedical ones. To achieve this whilst working within a primary mental health care model, practitioners employed a series of modifications to services to increase their ability to target the sociostructural realities facing HIV-affected women with mental health issues. This article suggests that beyond attention to the crucial issues of funding and human resources that face primary mental health care, attention must also be paid to promoting the development of policies that provide practitioners with increased and more consistent opportunities to address the complex social realities that frame the mental distress of HIV-affected women. SN - 1460-2237 SP - 917 AV - public ER -