Mental health in the Islamic Republic of Iran: achievements and areas of need

Mt, Yasamy; Shahmohammadi, D; Yazdi, Bagheri; Layeghi, H; Bolhari, Jafar; Em, Razzaghi; Bina, M; Mohit, A

doi:10.26719/2001.7.3.381

Cited by 39 publications

(7 citation statements)

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“…There have also been additional inservice training courses for GPs within the national primary health care system which covers the entire rural and most of the urban areas. 20,21 However, mental health services provided by GPs are associated with some challenges. Most of the pre-service training programs are conducted in tertiary settings where common mental disorders are not frequently seen, resulting in lower than optimal knowledge and skills for the management of depressive and anxiety disorders.…”

Section: General Practitionersmentioning

confidence: 99%

“…Since the late 1980s, mental health services have been integrated into the PHC at different levels. These services include the screening of mental disorders by a minimally trained healthcare worker to treatment by the GPs 20 and if indicated, referral to higher levels of the health system. In the beginning, the main focus was active case finding of serious neuropsychiatric disorders (consisting of psychotic disorders, mental retardation, and epilepsy).…”

Section: Primary Healthcare Systemmentioning

confidence: 99%

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Major Depressive Disorder in Iran: Epidemiology, Health Care Provision, Utilization, and Challenges

et al. 2022

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One in eight adults in Iran is estimated to have major depressive disorder (MDD) – a leading cause of disability in the country. Many remain undiagnosed, and some receive only partial treatment. An estimated 60% of those with MDD were reported to have received no treatment during the past year. In this paper, we have critically reviewed the current health-care structure in the country along with prevailing patterns of health-care service utilization. We have addressed the role of psychiatrists, general practitioners (GPs), psychologists, and other health-care personnel in the treatment and care of patients with MDD, with an emphasis on the quality of service provision. In addition, the strengths and weaknesses of primary healthcare (PHC), the health insurance system, and inpatient care have been discussed. We have paid attention to the contextual issues such as mental health literacy, stigma, and healthcare inequity where relevant. Finally, practical recommendations have been provided to improve the quality of care for patients with MDD in Iran.

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Section: General Practitionersmentioning

confidence: 99%

Section: Primary Healthcare Systemmentioning

confidence: 99%

Major Depressive Disorder in Iran: Epidemiology, Health Care Provision, Utilization, and Challenges

et al. 2022

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“…In Iran, mental health services can be accessed through diverse facilities like psychiatric hospitals and private clinics. However, for more than 40 years since mental health services were integrated into PHCs, PHCs have become a major source of easily accessible and affordable mental health care for all residents (12). So far, this method has shown remarkable bene ts by improving health outcomes and increasing access to healthcare services (13,14).…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Mental Disorders among Middle-Aged Population of Primary Healthcare Centers in Northeastern Iran

Talebi,

Taghipour,

Raouf-Rahmati

et al. 2023

Preprint

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Background Primary healthcare centers (PHCs) are the most accessible medical services in society. PHCs are responsible for screening, detecting, and treating health issues in people. This study aimed to investigate the prevalence of psychiatric disorders in middle-aged individuals who refer to PHCs and the potential of PHCs in diagnosing mental disorders. Methods This cross-sectional study was implemented at PHCs under the supervision of Mashhad University of Medical Sciences (MUMS) in northeast Iran. The enrolled subjects were middle-aged adults who had electronic medical records in SINA, an integrated health management system, and the electronic medical records of MUMS. The prevalence of psychiatric disorders by type and their relationship with demographic information was evaluated using a Chi-square test. Results This study involved 218,341 middle-aged participants. Prevalence of psychiatric disorders was 8.3%, and depression and anxiety were the most common psychiatric disorders. The prevalence of mental illnesses was significantly higher in women compared to men (10.1% vs 3.8%), those aged 46 to 60 compared to 30–45 years old (10.2% vs. 6.4%), and in rural residents compared to urban residents (11.5% vs. 6.5%). Conclusions Considering the previous studies in Iran, the prevalence of mental disorders among patients presenting to PHCs was noticeably lower than expected rates. It seems probable that this huge difference is due to poor screening and detection of mental illness in PHCs of MUMS. It is recommended that health policymakers pursue specific measures to make PHCs more helpful for people with mental health problems in the community.

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“…The program aimed to increase access to mental health services, promote mental health services in local culture, and increase public awareness of mental disorders [ 27 ]. However, there is concern about the inadequacy of mental health services due to continued industrialization and urbanization [ 28 ]. With regard to clozapine, it is used for eligible patients according to evidence-based clinical guidelines [ 29 ].…”

Section: Introductionmentioning

confidence: 99%

Iranian psychiatrists’ attitude towards clozapine use for patients with treatment-resistant schizophrenia: a nationwide survey

et al. 2022

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Background Clozapine has the greatest efficacy for treatment-resistant schizophrenia (TRS), even though its underutilization is not uncommon across different countries. This study aimed to investigate the knowledge and attitude of Iranian psychiatrists toward clozapine use. Method In this cross-sectional study, a questionnaire was distributed among psychiatrists registered with the Iranian Psychiatrists Association (including its provincial branches) to assess their knowledge and attitude towards clozapine use. A total of 282 psychiatrists completed the questionnaire. Descriptive analysis was used to describe demographic information, and Chi-square tests were conducted to determine if there is an association between academic position and work experience. All statistical analyses were performed using SPSS® version 25.0 for Windows, and a significance level of 0.05 was used. Results Most respondents (93%) acknowledged that they prescribed clozapine for their patients, and 74% believed that clozapine was more effective than other antipsychotic drugs. However, 43.3% of the respondents said they did not believe in the safety of clozapine. Difficulty initiating and having no firsthand experience in the superiority of clozapine were reported by 81.2 and 80% of the respondents, respectively. Our results also showed an association between having an academic position and access to appropriate facilities for the control and management of patients treated with clozapine and believing in the safety of clozapine (p < 0.05). Longer work experience (more than 15 years) was associated with a higher prescription of clozapine, belief in greater effectiveness of clozapine, and its safety (p < 0.0001). Conclusion Iranian psychiatrists had a good self-perception of knowledge about the efficacy of clozapine for patients with TRS, but concerns about serious side effects are common. Psychiatrists with longer work experience and academic positions were more optimistic towards clozapine use than the younger ones with no academic position. Considering the results in planning the strategies to decrease concerns about clozapine use is recommended.

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Mental health in the Islamic Republic of Iran: achievements and areas of need

Abstract: The development of mental health in the Islamic Republic of Iran is described with particular reference to the integration mental health into the primary health care system. The achievements made so far are outlined and the areas of need discussed.

Cited by 39 publications

References 0 publications

Major Depressive Disorder in Iran: Epidemiology, Health Care Provision, Utilization, and Challenges

Major Depressive Disorder in Iran: Epidemiology, Health Care Provision, Utilization, and Challenges

Prevalence of Mental Disorders among Middle-Aged Population of Primary Healthcare Centers in Northeastern Iran

Iranian psychiatrists’ attitude towards clozapine use for patients with treatment-resistant schizophrenia: a nationwide survey

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