Integrating mental health into primary care in Sverdlovsk

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Abstract:

Introduction: Mental disorders occur as frequently in Russia as elsewhere, but the common mental disorders, especially depression, have gone largely unrecognised and undiagnosed by policlinic staff and area doctors.

Methods: This paper describes the impact and sustainability of a multi-component programme to facilitate the integration of mental health into primary care, by situation appraisal, policy dialogue, development of educational materials, provision of a training programme and the publication of standards and good practice guidelines to improve the primary care of mental disorders in the Sverdlovsk region of the Russian Federation.

Results: The multi-component programme has resulted in sustainable training about common mental disorders, not only of family doctors but also of other cadres and levels of professionals, and it has been well integrated with Sverdlovsk's overall programme of health sector reforms.

Conclusion: It is possible to facilitate the sustainable integration of mental health into primary care within the Russian context. While careful adaptation will be needed, the approach adopted here may also hold useful lessons for policy makers seeking to integrate mental health within primary care in other contexts and settings.

Keywords: DEPRESSION; PRIMARY CARE; RUSSIAN FEDERATION; TRAINING

Document Type: Research Article

Affiliations: 1: Director WHO Collaborating Centre and Professor of Epidemiology and International Mental Health Policy, Institute of Psychiatry, King's College, London, UK 2: Chief Physician of the Sverdlovsk Oblast Ministry of Health, Sverdlovsk Oblast Ministry of Health, Ekaterinburg, Russia 3: Health Services Research Department, Institute of Psychiatry, King's College, London, UK 4: Professor of Primary Care Psychiatry, School of Community Based Medicine, NPCRDC, Manchester, UK 5: Department of Family Medicine Urals State Medical Academy, Department of Family Medicine, Ekaterinburg, Russia 6: Deputy Minister for Social Protection and Chief Psychiatrist of the Sverdlovsk Oblast Ministry of Health, Sverdlovsk Oblast Ministry of Health, Ekaterinburg, Russia 7: Moscow Research Institute of Psychiatry, Moscow Research Institute of Psychiatry, Moscow, Russian Federation 8: Research Fellow and Editor of Eurohealth, London School of Economics and Political Science, London, UK

Publication date: March 1, 2009

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