Descriptive Reports of Integration of Mental Health into the Primary Health Care (PHC) System in One of the Areas of Iran

Abstract

Integration of mental health into the Primary Health Care (PHC) system has been carried out many ago years in Iran. There are three services levels in the program including: Health house (The first level), rural health center (The second level), and city health center (The third level). Aim of the study was descriptive reports of the program in one of the regions of Iran. This was a descriptive cross sectional study in one of regions in Iran which has carried out this integration on it. Data gathered by monthly reports from one of regions of Hashtgerd, Savojbalagh, Alborz province, Iran. In Khurvin health house of Hashtgerd, Savojbalagh, Alborz province, Iran, integration of mental health performances into the PHC system including training, case finding, identifying, referral and follow-up of mentally patients were done by behvarzes. Most of patients under coverage this health house, were visited and followed by a general physician (GP) and they were cared by behvarzes. In Shahid Kohsar Golbaz rural health care center in there, which is one of the mental health service providing levels, diagnosis and treatment were done by a GP who was a director of the center. Patients who were visited at this center had been referred by Khurvin health house. Mild mental patients referred directly more than severe mental, epilepsy and mental retardation patients to this rural health care center. Psychiatric emergency cases were under covered by the same GP. Activities in this area were in a framework of a program and were including such activists: Mental health services, mental health training, mental health promotion, and mental health research. Level of case finding was excellent (for epilepsy) and poor (for mental retardation). On the bases of an report from the city health center in Hashtgerd, Savojbalagh, disorders were 1 case for severe mental disorder and mental retardation, 10 cases for mild mental disorder, 1-5 cases for other disorders per 100 under coverage population, and 1-3 cases for epilepsy per 1000 under coverage population. The most and the least common of disorders were mild mental disorder (56.9%) and mental retardation (6.9%). The most important achievement of the project of integration of mental health into the PHC is reduction of load of hospital professional services. This integration is successful in this area and can be continue with some changes and reforms that will be discussed in the paper.