Abstract
As explained by the World Health Organization (WHO) in 2000, the concept of health system responsiveness is one of the core goals of health systems. Since 2000, further efforts have been made to measure health system responsiveness and the factors affecting responsiveness, yet few studies have applied responsiveness concepts to the evaluation of mental health systems. The present study aims to measure responsiveness and its related domains in the mental health-care system of Tehran. Utilizing the same method used by the WHO for its responsiveness survey, responsiveness for outpatient mental health care was evaluated using a validated Farsi questionnaire. A sample of 500 public mental health service users in Tehran participated and subsequently completed the questionnaire. On average, 47% of participants reported experiencing poor responsiveness. Among responsiveness domains, confidentiality and dignity were the best performing factors while autonomy, access to care, and quality of basic amenities were the worst performing. Respondents who reported their social status as low were more likely to experience poor responsiveness overall. Attention and access to care were responsiveness dimensions that performed poorly but were considered to be highly important by study participants. In summary, the study suggests that measuring responsiveness could provide guidance for further development of mental health-care systems to become more patient orientated and provide patients with more respect.
Highlights
The Universal Declaration of Human Rights and its related conventions and guidelines, which have been ratified by governments globally, contain a wide range of health-related rights
In a previous qualitative study, we evaluated the applicability of this concept to mental health care in Iran
Our study showed that confidentiality was the best-performing domain in outpatient mental health care
Summary
The Universal Declaration of Human Rights and its related conventions and guidelines, which have been ratified by governments globally, contain a wide range of health-related rights. These include the right to health and health care, and the right of individuals with physical and mental disabilities to the highest quality health services [1]. Certain aspects of human rights, such as respecting patients’ autonomy, dignity, confidentiality, and choice of health care as well as client orientation aspects, such as the quality of basic amenities, prompt attention, and access to social support are covered in the concept of responsiveness
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