بازنگری برنامه ادغام سلامت روان در مراقبت های بهداشتی اولیه و برنامه پزشک خانواده

Objectives: Mental health in Iran has gone through a lot of ups and downs. Integration of mental health into primary healthcare system has increased access, particularly in rural areas. This has achieved remarkable results. After nearly three decades of the implementation of the program, due to demographic changes, needs and priorities changed and hence evaluative studies addressed the necessity of revising the program. Due to the expansion of the family physician program and improvement of primary mental healthcare within its framework, the program was subjected to revision. This paper reports on goals, strategies, and required actions within this revision. Method: In revising the Integration of Mental Health Services into Primary Health Care Program and the Family Physician Program, a combination of review literature and qualitative methods were used; and the national and international resources, experiences and reliable documents were reviewed. Group discussion, expert panels and Delphi technique were used to determine the shortcomings, goals, strategies, and hence reaching a consensus. Results: The program’s intended values in several domains and with specifying the general goal, were formed, and to achieve these goals, strategies in various areas including service delivery, training, information system, evaluation, advocacy, provision of essential medicines, quality improvement, and financial and administrative affairs were designed. For each strategy, objectives and measures were identified. Conclusion: In delivering the services, in addition to widening the coverage, they must be more community-based and the psychological services and promotion of mental health should be implemented in accordance with specific guidelines. The program’s focus must shift from widening the coverage to enhancement of the program. Strengthening information gathering system with the aim of conducting applied researches and designing a system for supporting patients with severe chronic disorders and their caregivers must be taken into consideration. Attention should be paid to recruiting competent staff, involvement of organizations, services providers and service users; and clients’ satisfaction indices should be used to improve the quality of care.  Implementation of the strategies and the mental health interventions with the preservation of the strengths of the previous plans is possible within the family physician or any other program for delivering mental health care with minimal modifications. However, it requires the decision makers’ will and seriousness, and the stability in the provision of necessary resources for the implementation of the program.