Chapter 32 Using information and evidence to improve mental health policy

Funk, Michelle; Morris, Jodi; Saxena, Shekhar

doi:10.1093/med/9780199565498.003.0147

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“…To develop a realistic project plan in order to achieve the objectives, an essential step is to perform a situation analysis that maps the existing mental health system with its functional and dysfunctional aspects, defining the context specific mental health services reform needs [15, 22, 23]. As the last thorough situation analysis of the mental health care system in Moldova dates from 2006 [24], this study aims to describe the mental health system in Moldova through a situation analysis to inform on mental health system reform needs before and at the initial stages of the MENSANA project (2007–2017).…”

Section: Introductionmentioning

confidence: 99%

Assessing the need for a mental health services reform in Moldova: a situation analysis

Mahon

Shields-Zeeman

Petrea

et al. 2019

Int J Ment Health Syst

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Background This study describes the Moldovan mental health system and reform needs before and during the initial phase of the MENSANA project (2014–2022) over the period 2007–2017. Methods A situation analysis was performed on: (1) the comparative need based on a country comparison using publicly available mental health system data; (2) the normative need based on a document review comparing the Moldovan mental health services structure with the norms of the WHO on the ideal mix of services, and a content analysis of interview and survey data from professionals (n = 93); (3) the felt need based on a content analysis of survey data from service users and carers (n = 52). Results The main finding from the comparative analysis is that mental health care remains largely institutionalized with little alternative care options in the community. Moldova has large mental hospitals and a high number of psychiatric beds per 100.000 population (59.8) in comparison with the South-eastern European Health Network and EU15 average in 2014 (47.63 and 36.61). The country also shows an inversion of the ideal mix of services. This points to the potential need for a mental health system reform which was confirmed by the perspectives of the professionals, service users and carers. The majority of respondents favour a mental services reform (82.8% of the professionals and 92.3% of the care recipients) and express numerous issues and reform needs with the most frequently mentioned being the need to: (1) reintegrate service users in society, community and family; (2) deinstitutionalise and implement CBMHS; (3) improve the accessibility and quality of services, and; and 4) address health workforce issues. Conclusion All three types of need explored in the situation analysis (e.g. comparative, normative and felt) point towards the necessity to reform the mental health system in Moldova. However, it is emphasized that this will only materialize when underlying socio-economic challenges that both constrain the implementation of community-based mental health services and foster the dependence of people with a mental illness on inpatient services are addressed.

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Section: Introductionmentioning

confidence: 99%