The nature of psychiatric problems in Primary health Care centers: the experience of a Community Mental Health Center in northeast of Iran

Abstract

Background Community Mental Health Centers (CMHCs) provide mental health services to patients at low cost, with less stigma, in a domiciliary. This is the first study to describe demographic characteristics, common mental disorders, referral status, and treatment discontinuation in patients at the only CMHC of Mashhad, northeastern Iran. Methods This cross-sectional study enrolled 662 patients who contacted this center between January 2014 and December 2021. We completed a checklist that included information on demographics, diagnosed mental disorders, referral status, and the number of psychiatric visits, all of which psychiatrists fully completed clinical records. The frequency distributions of all variables were carried out with SPSS11.5. In addition, the association between epidemiological findings and patient referral (referral system or self-referral) and the association between epidemiological findings and the number of psychiatric visits were examined by the Chi-square test. Results Of 662 patients, 472 (71%) women and 190 (29%) men were enrolled, and the mean age of all patients was 29 years. Among the 475 adult patients, 367 (77.3%) patients were married and had primary or secondary education (40.4%), and the majority of them were housewives (56.4%). Major Depression Disorder (32%), Generalized Anxiety Disorder (18.3%) were the two most common mental illnesses in patients. Large proportions of the patients (70.7%) were referred to this center via the referral system. Moreover, non-working patients (housewives and unemployed patients) and the female gender were associated with more referrals to this center through the referral system. 431 patients (65.1%) did not return for a second visit, and the higher number of psychiatric visits was associated with a lower level of education. Conclusions Based on the results of this study, most of the patients in this center had a low socioeconomic level. Most of them were referred through the referral system, and gender and employment significantly contributed to referral via the referral system. The majority of patients discontinued treatment after the first psychiatric visit, and this was associated with the level of education.