PERFORMANCE EVALUATION OF STAFF WORKING IN PRIMARY MENTAL HEALTH CARE UNITS AT PRIMARY HEALTH CARE CENTERS

Dr. Kamal Jummah Ameen*

Introduction: The quality of care provided by Primary Mental Health Care Units (PMHCUs), which serve as a cornerstone for delivering community-based mental health services depends largely on the performance of their staff. Consequently, systematic performance assessment is essential for evaluating competence, identifying training gaps, and enhancing service effectiveness; yet, despite this importance, current assessment procedures are often inadequate. Objectives: To evaluate the performance of staff in Primary Mental Health Care Units (PMHCUs) at primary health care centers in Kirkuk City, and to examine associations with demographic and professional variables (gender, educational level, training, years of experience, and willingness to work in these units). Methods: A descriptive cross-sectional study was conducted involving 78 staff members from primary health care units, selected using a convenience sampling method between June 25 and July 15, 2026. Data were collected via a self-administered questionnaire comprising demographic questions and an Arabic-language staff performance assessment tool—a validated instrument used for quality improvement in primary health care units. Relationships were analyzed using descriptive statistics (frequencies, percentages, arithmetic means, and standard deviations) and inferential statistical tests. Ethical approval was obtained from the Kirkuk Health Directorate, and participants signed a written informed consent form. Results: The overall performance of personnel in primary mental health care units was moderate to high (mean = 3.42, SD = 0.58), with 57.7% of participants achieving scores in the moderate to high level. Basic competencies received the highest rating (mean = 3.85; 79.5% acceptable), while continuous training (mean = 2.91; 65.4%), updated clinical knowledge (mean = 2.76; 71.8%), and crisis management skills (mean = 2.88; 69.2%). Staff performance was significantly positively associated with training exposure (mean = 3.55; F = 4.26, p = 0.018) and educational qualification (mean = 3.48; t = 3.12, p = 0.003), but there was a significant negative association with sex (mean = 2.72; t = 3.45, p = 0.002). Additionally, there were considerable positive associations between performance and years of experience (mean = 3.62; t = 3.89, p = 0.001) and willingness to work in PMHCUs (mean = 3.69; t = 4.14, p < 0.001). These results highlight the necessity of focused ongoing professional development and actions to improve clinical expertise and crisis management skills. Conclusions: Staff in primary mental health care units demonstrated performance levels ranging from average to excellent, with "core competencies" emerging as a key strength; however, notable gaps were observed in crisis management, periodic training, and familiarity with the latest clinical knowledge. Higher academic qualifications, intensive training, years of practical experience, and a readiness to work in these units were strongly associated with outstanding performance, although the impact of these factors varied by gender. Recommendations: Enhancing staff performance through continuous competency-based training, ongoing professional development, empathy-based supervision, periodic performance evaluations, and regular, effective clinical education—with a particular focus on improving crisis management skills and supporting workforce development in Community Mental Health Units (PMHCUs).