Historical Research on Iranian Mental Health Programs: A Qualitative Study

Background: Mental illness causing mild to severe disturbances in thinking, perception and behavior, can strike anyone without any limitation such as age, sex, race, creed etc. Prevalence of mental disorders in various global studies is different between 7/3% to 39/8% and in IRAN varied from 5/62% to 53/7% in local epidemiological investigations in rural or urban area or a province. Also, National epidemiological studies in IRAN showed that prevalence of mental disorders were 12/6% in 1998, 21% in 2000 and 17/1% in 2002. According to these and pay attention that 5 from 10 reasons of Global Burden of Disease (GBD) related to mental disorders that cause dysfunctions of patients, their families and community, therefore take care of mentally ill patients and their families will be necessary for promotion of mental health. Because the main goals of all health care systems are promotion of health and quality of life enhancement, thus accuracy and effectiveness of mental health programs are important. Study objectives: The aims of this study were review and critique of mental health programs in IRAN. Methods: Qualitative historical study was carried out to obtain above objectives. Results: There were five important stages in development of mental health programs in IRAN as following: 1-Primary care for mentally ill patients provided by not specialist physicians and not educated practitioner nurses in a little small hospital at 1910. 2- Specific care for mentally ill patients provided by psychiatrists and educated nurses in modern psychiatric hospitals in Tehran,Shiraz,Esfahan, Tabriz and Mashhad at 1930-1960. 3- Community based mental health programs were done by health care system and epidemiological studies about mental disorders started at 1970. 4- Mental health added to primary health care services as 9th part of PHC programs at 1991. 5- Participation of health volunteers in mental health programs started at 1994. Critique of programs, protocols, legal documents, scientific bulletin, etc in these stages showed that although movement from special hospital based mental health cares to community based programs and participation of community members in mental health programs were effective in mental health promotion, but, attention to educational curative needs of family members of mentally ill patients and use of them as informal care provider were not appear in these programs clearly. Conclusions/Recommendations: According to results and pay attention to this fact that health care programs won’t successful until peoples will participate in their health care process, researchers were recommended that current national mental health programs in IRAN should revise for more family member participation in care of their patients, attention to all needs of them and provide comprehensive mental health program that commensurate with new community needs.

mental disorder, historical research, mental health program, primary health care, IRAN, qualitative research