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Investigating South African recommendations for nurse prescribing of mental healthcare drugs

Mental illness forms part of the South Africa’s quadruple burden of disease. Estimates propose that approximately a quarter of the country’s population is depressed, with grouped mental disorders contributing the largest number of years lived with disability in the 2019 Global Burden of Disease study. Accessibility to mental healthcare services is constrained due to, among others, primary healthcare infrastructure limitations, shortages of mental healthcare practitioners, and stigmatisation of mental illness. Various diseases, including notable communicable diseases such as the human immunodeficiency virus, contribute to the burgeoning mental health challenges of the country, highlighting the interlink between such co-morbidities. As such, the South African National Strategic Plan for HIV, TB and STIs (2023 to 2028) has recommended that healthcare practitioners require further development of competencies to screen and support mental health and substance use disorders. The plan suggests bolstering mental healthcare treatment in the country by enabling professional nurses to prescribe and dispense medication to manage common mental health conditions in support of a doctor. The management of mental health conditions is complex, including psychotherapeutic and pharmacotherapeutic modalities. Given the shortage of available mental healthcare practitioners and specialists that can manage patients with mental illness, the recommendations to capacitate professional nurses in non-medical prescribing of medicine relevant to common mental health illnesses may promote accessibility to pharmacotherapeutic modalities. In doing so, accessibility to medication may be promoted, thus mitigating an aspect of the current healthcare crisis. Although there may be benefits associated to non-medical prescriptions, concerns on the potential impact on mental health treatment strategies, misdiagnoses, irrational prescribing, educational training necessitated, and interprofessional tension with other mental healthcare specialists and prescribing authorities have been raised.

The project is tailored to accommodate either an MSc or PhD candidate to explore the influence of the various factors associated with the proposed nurse non-medical prescription of mental healthcare drugs within the South African landscape. The project is offered on a full-time basis in the Department of Pharmacology at the University of Pretoria under the primary supervision of Prof Werner Cordier in collaboration with Prof Champion Nyoni (University of the Free State). The accepted candidate must be able to start the programme by January 2025 so that it can be completed by August 2026 (MSc) or 2027 (PhD).

Eligibility criteria for the MSc or PhD Pharmacology programme

• A grade point average ≥65% for a relevant NQF 8 (MSc candidate) or 9 (PhD candidate) level degree in the biological sciences, which includes clinical professions such as nursing;

• Undergraduate pharmacology (FAR 381 and FAR 382, or equivalents thereof) with an average ≥60%;

  • In exceptional circumstances, applicants who are not in possession of such modules may take this during their programme, however, this should not be seen as a guaranteed option;

• International students must have their foreign qualifications verified by SAQA

  Minimum required skills and/or experience for the research project

  • English-language proficiency, with strong written and oral communication skills;

  • Good understanding of research practice, including sourcing of relevant literature; and

  • Qualitative research experience, including thematic analyses.

Beneficial skills and/or experience for the research project

• Clinical mental healthcare experience;

• Creation of questionnaires; and

• Conduction of focus group interviews.

  Interested parties should apply for the programme by the 31st of July (PhD) or 31st of August (MSc)

• Application details, including all required documentation, is available on our website

• Queries should be addressed to Prof Werner Cordier (werner.cordier@up.ac.za), however, please copy Mrs Christa Swart (christa.swart@up.ac.za) for her knowledge and capturing of applicant information