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Integrating mental health services into the primary health care system: The need for reform in Iran

Hajebi, A. and Sharifi, V. and Abbasinejad, M. and Asadi, A. and Jafari, N. and Ziadlou, T. and Khadem, S. and Asgardoon, M.H. and Damari, B. (2021) Integrating mental health services into the primary health care system: The need for reform in Iran. Iranian Journal of Psychiatry, 16 (3). pp. 320-328.

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Abstract

Objective: The main objective of this study was to review aspects of the current situation and structure of the integrated mental health care services for planning a reform. Aspects of the newly designed infrastructure, along with specification of duties of the various human resources, and its relation with Iran's Comprehensive Mental and Social Health Services (the SERAJ Program), will also be presented Method: This is a study on service design and three methods of literature review, deep interview with stakeholders, and focused group discussions. In the literature review, national and international official documents, including official reports of the World Health Organization (WHO) and consultant field visits, were reviewed. Deep semi-structured interviews with 9 stakeholders were performed and results were gathered and categorized into 3 main questions were analyzed using the responsibility and effectiveness matrix method. The Final results were discussed with experts, during which the main five-domain questions were asked and the experts' opinions were observed. Results: In this study, the main gaps of the public mental health care (PHC) services in Iran were identified, which included reduction of risk factors for mental disorders, training the general population, early recognition and treatment of patients with mental disorders, educating patients and their families, and rehabilitation services. The new model was then proposed to fill these gaps focusing on increasing access, continuity of care, coordination in service delivery, and comprehensiveness of care. A mental health worker was placed besides general healthcare workers and general practitioners (GPs). Services were prioritized and the master flowchart for mental health service delivery was designed. Conclusion: A reform was indeed necessary in the integrated mental health services in Iran, but regarding the infrastructure needed for this reform, including human and financial resources, support of the senior authorities of the Ministry of Health (MOH) is necessary for the continuity and enhancement of services. In this model, attention has been given to the principles of integrating mental health services into primary health care. Current experience shows that the primary health care system has been facing many executive challenges, and mental health services are not exclusion to this issue. Monitoring and evaluation of this model of service and efforts for maintaining sustainable financial resources is recommended to make a reform in this system and to stabilize it. Copyright © 2021 Tehran University of Medical Sciences. Published by Tehran University of Medical Sciences.

Item Type: Article
Additional Information: cited By 0
Subjects: روانپزشکی WM
پرستاری wy
مقالات نمایه شده محققین دانشگاه در سایت ,Web of Science ,Scopus
Divisions: معاونت تحقیقات و فناوری
Depositing User: GOUMS
Date Deposited: 10 Aug 2021 07:42
Last Modified: 10 Aug 2021 07:42
URI: http://eprints.goums.ac.ir/id/eprint/11151

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