District health facility managers play a significant role in provision of primary health care (PHC) services, particularly in integration of mental health services into the PHC level and developing a district health information system, which includes an integrated mental health information system (MHIS). The aim of the study was to explore the views and involvement of district health facility managers in the mental health information processing and utilization in improving mental health service delivery within the context of PHC. The study employed a qualitative research approach. Fourteen facility mangers were recruited using purposive sampling techniques, and interviews were conducted in 2012 and 2013. The interview data were analysed using thematic content analysis. The study identified that mental health information processing systems are fragmented and inadequate for decision making, and it was not known how to use mental health information. Lack of knowledge in information processing and utilization, as well as poor information infrastructure and networking was associated with poor understanding about mental health, not considering mental health as one of the priorities within the district health services, and lack of higher officials’ interest in the mental health development programme. Also notable were the attitudes towards mental illness, which were a major problem. These findings have major implications, such as behavioral /attitudinal risk factors of higher officials, policy makers, and the community for MHIS development and interventions in the reduction of mental health problems in South Africa.Department of HE and Training approved lis