Urban Mental Health Initiative: Developing Interdisciplinary Collaboration, the Role of the Family Physician in Management of Severe Mentally Ill Patients
Authors:   Mental Health Research Center, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran., Malakouti Seyed Kazem , Keshavarz Akhlaghi Amirabbas ,   Mental Health Research Center, Iran University of Medical Sciences, Tehran, Iran., Shirzad Fatemeh ,   Spiritual Health Research Center, Iran University of Medical Sciences, Tehran, Iran., Rashedi Vahid ,   School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran., Khlafbeigi Mitra ,   Department of Occupational Therapy, School of Rehabilitation Sceinces, Iran University of Medical Sceinces, Tehran, Iran., Moradi Lakeh Maziar ,   Family Health Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran., Hajebi Ahmad ,   Department of Psychiatry, Research Center for Addiction and Risky Behaviors (ReCARB), Iran University of Medical Sciences, Tehran, Iran.
Published: July 2021

Introduction: Mental health in Iran was approved in 1988. However, and then this program was integrated into the primary care system in our country and was implemented within the villagers' family physician program with great success. In urban areas, there is no structured health network. However, regarding the demographic changes in the country's population, huge sprawling of cities, and the changes in urban-rural population proportion, demands for a coherent plan to provide mental health services to the urban population are felt more than ever. This study aimed to investigate the feasibility and establishment of a model of urban mental health network for severe psychiatric patients. Methods: This plan is based on resource reviews, Use the experiences of other countries, Model World Health Organization, The services available in the country currently run by the beneficiary organizations, Description of the responsibilities of the responsible organizations, Collaboration between the Ministry of Health and various organizations responsible for mental health, Having the views of national expert and international constant in this field from other countries cooperated with the aim of examining how to compile a coherent and integrated urban health service plan. This model is estimated by community-based services for 100,000 people. Results: The proposed model for providing immediate psychiatric services with greater cohesion and increasing training and skills capacity among staff 110, 115, 1480, and 123 services, as well as a space for hospitalization of 3 to 5 emergency patients next to the public hospital, is recommended. Depending on the number of patients in a population of 100,000, we will need community-based services, including 2 to 3 home visit teams to cover 80 patients per team, and 3 daily centers to provide services to 40 patients. If community-based services are provided, we will need 12 acute psychiatric beds and 5 beds for mid-term rehabilitation to provide inpatient services. In terms of employment and accommodation, 50 patients will need supported employment, respectively, and two apartments with an area of about 60 meters will be needed to accommodate about eight people. The provision of the above services requires the equal participation of the interested organizations. The family physician will play an essential role in continuing medical care for severe and mild psychiatric patients under the constant supervision of specialists Discussion and Conclusion: To achieve a better model of mental health services in cities that can cover a wide range of people in urban areas and at various levels from prevention and care to treatment and rehabilitation, we need the coordination between the organizations providing these services for the accurate planning of the interests of each organization, elimination of duplicate services, and saving human capital and resources of the country.