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Care for common mental health problems in medium-resourced countries has been conceptualized by the World Health Organization as needing to be provided by primary health care personnel, in particular primary health care nurses. This study, which comprised a file audit of a psychological referral service at primary level in South Africa, suggests that in contexts where specialized psychological services are lacking, the demand for mental health services includes that of psychometric assessment services for mental retardation and/or scholastic problems. It is argued that in these contexts, third generation health systems reforms should be applied to the provision of care for more common mental health problems as well as mental retardation and/or scholastic problems in medium-resourced countries. This would require the insertion of a 'package' comprised of both psychological assessment and intervention services. It is suggested that in South Africa, such a 'package' could be provided by the new professional category of 'counsellor', which the Professional Board of Psychology of the South African Health Professions Council has recently accredited.

Primary level psychological services in South Africa: can a new psychological professional fill the gap?