A primary mental health programme in Eastern Province, Saudi Arabia, 2003–2013
Abstract:Background: Globally, mental health problems are increasing. The Ministry of Health in the Eastern Province of Saudi Arabia (SA) has established a Primary Mental Health Care (PMHC) programme to meet the increasing demand of mental health problems in the community, and to act as a model for integrating mental health with primary care.
Objective: The survey aimed to explore the outcomes of follow-ups to patients seeking care at PMHC programme clinics in the Eastern Province of SA.
Design and setting: We conducted a retrospective chart review of three PMHC centres located in Dammam, Al Khobar and Qateef regions of the Eastern Province since their establishment in 2003. ICD-10 code was used to diagnose the common mental health problems. Follow-ups of these patients were analysed to see the pattern and outcome of mental health management at primary care level. Outcome was determined for frequency of diagnosis, type of diagnosis, followup rate and response to treatment. A chi-square test was used to compare socio-demographic variables in patients' outcome with statistical significance at P-value = 0.05.
Results: There were a total of 3,548 patients, with a mean age of 20.06±15.8 and females being high in proportion (53.2%). The gender difference was obvious for prevalence of mental illnesses at different age groups: 43.2% of male patients were between 1–18 year (P<0.0001), and 34.5% of female patients were between 30–50 years (P<0.001).
Other significant demographics were single males, students, housewives and elementary school children. The most common diagnosis was anxiety (30.2%) with its different types, followed by depression (23.3%). The follow-up of patients revealed that 47.3% improved, 28.2% were in remission, and only 1.2% did not respond. Some 0.5% were lost to the follow-up, and 4.8% were referred to psychiatric hospital. Diabetes and hypertension were prevalent among depressed patients, while gastrointestinal complaints were common among patients with anxiety (P<0.001).
Conclusion: Our results indicate that the integration of mental health services in primary health care is quite successful in achieving targeted outcomes. This effect can boost the confidence of stakeholders to make mental services available at community level with its comprehensive, continuous care in primary health care centres all over the country.
Document Type: Research Article
Affiliations: 1: Family and community medicine consultant, Director of Postgraduate Family Medicine Programme and Supervisor of Primary Mental Health Programme, Eastern Province Ministry of Health, KFHU PO Box 40248, Al-Khobar-31952, Saudi Arabia; mabna@ yahoo.com 2: Primary care mental health physician, Eastern Province Ministry of Health, Saudi Arabia 3: Director of General Health Affairs, Eastern Provence Ministry of Health; Developmental Behavioural Paediatrics Consultant; Assistant Professor, King Saud University, Saudi Arabia 4: Family and community medicine consultant; Director, General Public Health Administration, Eastern Province Ministry of Health, Saudi Arabia 5: Psychologist; Supervisor, General Al-Amal Complex for Mental Health, Dammam, Saudi Arabia 6: Vice General Director Assistant of General Health, Eastern Province Ministry of Health, Saudi Arabia 7: Associate Professor and Consultant Psychiatrist, College of Medicine, University of Dammam; Chairman, Department of Psychiatry, King Fahd Hospital; President, Saudi Psychiatric Association, Saudi Arabia
Publication date: December 1, 2013