Community Action Package in Iran's Comprehensive Mental and Social Health Services (the SERAJ Program)
Objective: The social component of health plays a significant role in improving the mental health of the people of a district. A national program on providing comprehensive social and mental health services, entitled “SERAJ”, was developed and piloted in three districts of Iran. The present study aims to determine its model for improving the indicators of the social component of mental health.
Method: This study is a system design for which a literature review, interviews with experts, and focused group discussions with stakeholders were used.
Results: Community action in promoting the mental health of the districts has three main components: strengthening intersectoral collaboration through the memorandum of understandings (MoU), increasing people's participation by establishing People’s Participation House (PPH) with the presence of the representative of current People’s network, and social protection of people suffering from mental disorders by establishing the Social Support Unit (SSU) for self-reliance activity. All three components are controlled by the governor and with supervision and technical consult of the health network of the district and stakeholder participation.
Conclusion: The model uses the inner capacities of the city instead of creating new structures. The prerequisites for the effective function of the main three components are educating departments, educating members of the PPH, and hiring a social worker at the SSU. The effective measures taken by the departments to reduce the risk factors for mental disorders are dependent on the technical and financial support of relevant organizations at the provincial and national levels.
2. Uher R, Zwicker A. Etiology in psychiatry: embracing the reality of poly-gene-environmental causation of mental illness. World Psychiatry. 2017;16(2):121-9.
3. Lund C, Brooke-Sumner C, Baingana F, Baron EC, Breuer E, Chandra P, et al. Social determinants of mental disorders and the Sustainable Development Goals: a systematic review of reviews. Lancet Psychiatry. 2018;5(4):357-69.
4. Organization Health Organization. The World health report: 2004: changing history: World Health Organization; 2004.
5. Murphy SK, Maxwell SD. Pre-and Perinatal Risk Factors for Serious Mental Disorders: Ethical Considerations in Prevention and Prediction Efforts. Ethics in Mental Health..2018.
6. Jorm AF, Mulder RT. Prevention of mental disorders requires action on adverse childhood experiences. Aust N Z J Psychiatry. 2018;52(4):316-9.
7. Forbes MK, Rapee RM, Krueger RF. Opportunities for the prevention of mental disorders by reducing general psychopathology in early childhood. Behav Res Ther. 2019;119:103411.
8. Wakschlag LS, Roberts MY, Flynn RM, Smith JD, Krogh-Jespersen S, Kaat AJ, et al. Future Directions for Early Childhood Prevention of Mental Disorders: A Road Map to Mental Health, Earlier. J Clin Child Adolesc Psychol. 2019;48(3):539-54.
9. Costello EJ. Early Detection and Prevention of Mental Health Problems: Developmental Epidemiology and Systems of Support. J Clin Child Adolesc Psychol. 2016;45(6):710-7.
10. Schaan VK, Schulz A, Schächinger H, Vögele C. Parental divorce is associated with an increased risk to develop mental disorders in women. J Affect Disord. 2019;257:91-9.
11. Wolchik S, Christopher C, Tein JY, Rhodes CA, Sandler IN. Long-term Effects of a Parenting Preventive Intervention on Young Adults' Attitudes Toward Divorce and Marriage. J Divorce Remarriage. 2019;60(4):283-300.
12. Christopher C, Wolchik S, Tein JY, Carr C, Mahrer NE, Sandler I. Long-term effects of a parenting preventive intervention on young adults' painful feelings about divorce. J Fam Psychol. 2017;31(7):799-809.
13. Mishara BL, Chagnon F. Why mental illness is a risk factor for suicide. The international handbook of suicide prevention 2nd ed West Sussex, UK: John Wiley & Sons. 2016:594-608.
14. Sedgh G, Singh S, Hussain R. Intended and unintended pregnancies worldwide in 2012 and recent trends. Stud Fam Plann. 2014;45(3):301-14.
15. Bijl RV, de Graaf R, Hiripi E, Kessler RC, Kohn R, Offord DR, et al. The prevalence of treated and untreated mental disorders in five countries. Health Aff (Millwood). 2003;22(3):122-33.
16. Dulmus CN, Rapp-Paglicci LA. The prevention of mental disorders in children and adolescents: Future research and public-policy recommendations. Families in Society. 2000;81(3):294-303.
17. Harkko J, Virtanen M, Kouvonen A. Unemployment and work disability due to common mental disorders among young adults: selection or causation? Eur J Public Health. 2018;28(5):791-7.
18. Barth RP. Preventing child abuse and neglect with parent training: Evidence and opportunities. The Future of children. 2009 Oct 1:95-118.
19. Rona RJ, Hooper R, Jones M, Hull L, Browne T, Horn O, et al. Mental health screening in armed forces before the Iraq war and prevention of subsequent psychological morbidity: follow-up study. Bmj. 2006;333(7576):991.
20. Rozanov V, Frančišković T, Marinić I, Macarenco MM, Letica-Crepulja M, Mužinić L, Jayatunge R, Sisask M, Vevera J, Wiederhold B, Wiederhold M. Mental health consequences of war conflicts. InAdvances in Psychiatry 2019 (pp. 281-304). Springer, Cham.
21. Whitley J, Smith JD, Vaillancourt T, Neufeld J. Promoting mental health literacy among educators: A critical aspect of school-based prevention and intervention. InHandbook of school-based mental health promotion 2018 (pp. 143-165). Springer, Cham.
22. Yasamy MT, Shahmohammadi D, Bagheri Yazdi SA, Layeghi H, Bolhari J, Razzaghi EM, Bina M, Mohit A. Mental health in the Islamic Republic of Iran: achievements and areas of need. EMHJ-Eastern Mediterranean Health Journal, 7 (3), 381-391, 2001. 2001.
23. Damari B, Alikhani S, Riazi-Isfahani S, Hajebi A. Transition of Mental Health to a More Responsible Service in Iran. Iran J Psychiatry. 2017;12(1):36-41.
24. DAMARI B, HEIDARNIA MA, RAHBARI BM. Role and performance of Iranian NGOs in community health promotion. Payesh, 2014.
25. 5th 5-years economical, social and cultural development plan act of Iran. 2011.
26. Vosoogh Moghaddam A, Damari B, Alikhani S, Salarianzedeh M, Rostamigooran N, Delavari A, et al. Health in the 5th 5-years Development Plan of Iran: Main Challenges, General Policies and Strategies. Iran J Public Health. 2013;42(Supple1):42-9.
27. Damari B, Kamrava K, Kazemi-Asl S, Momtaz-Manesh N, Vosoogh-Moghaddam A, Mirzaei H. Determining Educational Needs of Educational and Research Centers of Excellence: Road Map of Scientific and Educational Centers of Excellence in Medical Sciences. SALAMAT IJTIMAI (Community Health). 2018 Dec 1;5(1):87-93.
28. Taghva A, Farsi Z, Javanmard Y, Atashi A, Hajebi A, Noorbala AA. Strategies to reduce the stigma toward people with mental disorders in Iran: stakeholders' perspectives. BMC Psychiatry. 2017;17(1):17.
29. Iran SCo. National Population and Housing Census of Iran. 2016.
30. Damari B, Vosoogh Moghaddam A. improving approaches of intersectoral collaboration for health by health and food security high council in IR Iran. Journal of School of Public Health and Institute of Public Health Research. 2014 Jan 10;11(3):1-6.
31. Public Health Agency of Canada. Crossing sectors: experiences in intersectoral action, public policy and health; 2007.
32. Connor DM. A new ladder of citizen participation. National Civic Review. 1988 May;77(3):249-57.
33. Montazeri A, Riazi-Isfahani S, Damari B. How to integrate social care services into primary health care? An experience from Iran. Medical journal of the Islamic Republic of Iran. 2016;30:408.
34. Weiss D, Lillefjell M, Magnus E. Facilitators for the development and implementation of health promoting policy and programs - a scoping review at the local community level. BMC Public Health. 2016;16:140
35. Esmaeili R, Hadian M, Rashidian A, Shariati M, Ghaderi H. Family medicine in Iran: facing the health system challenges. Glob J Health Sci. 2014;7(3):260-6.
36. Taylor-Robinson DC, Lloyd-Williams F, Orton L, Moonan M, O'Flaherty M, Capewell S. Barriers to partnership working in public health: a qualitative study. PLoS One. 2012;7(1):e29536.
37. Babashahy S, Baghbanian A, Manavi S, Sari AA, Olyaee Manesh A, Ronasiyan R. Towards reforming health provider payment methods: evidence from Iran. Health Scope. 2017 Feb 1;6(1).
|Issue||Vol 16 No 1 (2021)|
|Community Action Mental Health Public Participation Self-Reliance Social Determinants of Health|
|Rights and permissions|
|This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.|