Studying the Performance, Achievements and Challenges of Providing Community-Oriented Mental Health Services: A Preliminary Case Study

Abstract

Background. Primary health care system provides appropriate prevention and primary mental care services for the rural population, but not in urban areas. Therefore, the Community Mental Health Center (CMHC) was developed to provide mental health services in urban areas. The present study aimed to outline the performance, achievements and challenges of CMHC in one of the main cities in north west of Iran. Methods. This was a case study with in-depth interview approach. The outcomes, implications, and challenges of CMHC in Tabriz city of Iran were evaluated from 2015 to 2019 using three methods: 1) in-depth interviews with two executive managers, 2) focus group discussion with managers and mental healthcare providers, and 3) collection of mental health care indicators which was collected from patient health records. After the final evaluations, the challenges and appropriate recommendations were presented for improving mental health services in urban areas. Results. A total of 17 specialists and general medical doctors collaborated in conducting the study. During the study, 1053 initial visits and/or screenings, and 2313 patients with psychological disorders were identified and recorded. Moreover, a total of 988 mental training sessions were held for patients and their families. Five main themes, including the necessity for establishment and objectives, implementation process, achievements, challenges, and recommendations, with many sub-themes were identified during in-depth interviews and focus group discussions. Conclusion. It seems that CMHC is an appropriate strategy and model for providing basic mental health services, especially in metropolitan cities. Longitudinal studies with a randomized controlled trial design as well as cost-effectiveness evaluation studies are required to confirm CMHC in the Iranian context.