Mental Health Services Integration in Primary Health Care in Iran: A Policy Analysis

Abbasali Dorosti; Majid Karamouz; Vahab Asl Rahimi; Solmaz Azimzadeh; Hojatolah Gharaee; Saber  Azami-Aghdash; Mostafa Farahbakhsh

doi:10.18502/ijps.v19i1.14339

Abbasali Dorosti Department of Anesthesiology, Tabriz University of Medical Sciences, Tabriz, Iran.
Majid Karamouz East Azerbaijan Province Health Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Vahab Asl Rahimi Department of Mental Health, East Azerbaijan Province Health Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Solmaz Azimzadeh Tabriz Health Services Management Research Center, Iranian Center of Excellence in Health Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran.
Hojatolah Gharaee Health Center of Hamadan City, Hamadan University of Medical Science, Hamadan, Iran.
Saber Azami-Aghdash Medical Philosophy and History Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Mostafa Farahbakhsh Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

DOI: https://doi.org/10.18502/ijps.v19i1.14339

Keywords: Integration; Mental Health; Policy Analysis; Primary Health Care

Abstract

Objective: The National Mental Health Services (N-MHSs) in Iran was integrated with Primary Health Care (PHC) in 1988. This study aimeds to analyze the policy of integrating N-MHSs in PHC, focusing on the analysis of the current situation, pathology, and the existing challenge.

Method: This qualitative research was conducted in 2020 using a case study approach. This study used the policy triangle model to analyze the policy. The required data were collected via interviews, literature review, and document analysis. The interviews were conducted with 23 experts, stakeholders across the country who were selected through purposive sampling, and the data were analyzed using the content-analysis method.

Results: The main goals of this policy were to raise mental health literacy among the people and eliminate its stigma in the society, while implementing the referral system for N-MHSs. Twenty weaknesses were extracted in eight areas, including negative views of mental health, weaknesses in human resource training, compensation for the service of psychologists, unfavorable working conditions of the workforce, inappropriate service delivery facilities, lack of meaningful communication between different levels of service delivery, poor inter-sectorial communication, and the challenging nature of mental health care. De-stigmatizing psychological disorders in the society and identifying hidden patients are some of the most significant achievements of this policy.

Conclusion: Despite the successful implementation and significant achievements in integrating N-MHSs in PHC, the results of the present study indicate that there are many challenges in this field that require serious planning and attention from relevant authorities.