The Community Action Program Works to Improve Mental Health at the District Level: The Evaluation of the Community Action Program in Districts of Iran

Behzad Damari; Vandad Sharifi; Mohammad Hossein Asgardoon; Ahmad Hajebi

doi:10.18502/ijps.v16i4.7233

Behzad Damari Department of Governance and Health, Neuroscience Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Vandad Sharifi Department of Psychiatry, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Mohammad Hossein Asgardoon Department of Governance and Health, Neuroscience Research Institute, Tehran University of Medical Sciences, Tehran, Iran
Ahmad Hajebi Research Center for Addiction and Risky Behaviors (ReCARB), Psychiatric Department, Iran University of Medical Sciences, Tehran, Iran.

DOI: https://doi.org/10.18502/ijps.v16i4.7233

Keywords: Community Participation; Health Literacy; Intersectoral Collaboration; Mental Health; Social Stigma

Abstract

Objective: Three categories of interventions are considered for reducing the prevalence of mental disorders in Iran: mental health promotion, increasing mental health and social service utilization and controlling mental health risk factors. In this regard, we designed a community action program in a national plan to provide comprehensive social and mental health services (SERAJ) that were implemented as a pilot in three districts of Iran: Bardasir, Oslo, and Quchan. In this study, we have reviewed the results of this pilot project.

Method: This study was conducted based on the collaborative evaluation model; first, the program was described and the evaluation indicators of each component of the program were determined. Stakeholders were determined; also, data were collected through literature review, semi-structured interview, and focused group discussion and were analyzed by thematic analysis methods.

Results: The community action program consists of four components: A Memorandum of Understanding (MoU) between the departments of the districts, People’s Participation House (PPH), Self-reliance Unit (SRU), and actions taken for stigma reduction. A total of 48% of the actions set out in the three MoU of three districts have been executed. The PPH was formed in all three districts. A total of 816 social referrals were admitted to SRU for which a self-reliance process has been initiated. Moreover, 47% of referrals have received services and at least 10 messages for stigma reduction and promoting mental disorders have been sent from different sources at the district level.

Conclusion: Strengthening vertical cooperation between the national and provincial levels is essential for the full implementation of the Memorandum of Understanding (MoU) and self-reliance processes. Referring individuals for receiving social support with collaboration between the primary and secondary programs reported to be successful, but feedback to the primary and secondary levels which provides basic and specialized services, is not transparent. Therefore, we suggest an electronic system as an option to solve this problem. The careful selection of representatives of the people's network and empowerment of PPH and directors of the district on community action skills are essential. The experiences of the governors and chairs of health networks of the three districts should be presented at a national conference.