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The Integration of Mental Health Care in Rural Iran

Published online by Cambridge University Press:  01 January 2022

Alex Keivahn Smith*
Affiliation:
Yale University

Abstract

Iran’s rural mental health care system emerged in a context that included experiments in health care prior to the 1979 Revolution and the establishment of a primary health care (PHC) system after the Revolution. Beginning in the 1980s, Iran integrated mental health care into the existing PHC system by treating mental illness much like a communicable disease. Iran advanced treatment options compatible with the existing system, added new training for existing care providers, and incorporated specialists. The integration of mental health care led to the rapid improvement of health outcomes. The integration also created the unintended consequence of privileging pharmaceutical treatments and overlooking mental illnesses affected by somatization.

Type
Articles
Copyright
Copyright © Association For Iranian Studies, Inc 2019

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Footnotes

The author would like to thank Professors Kevan Harris, Mirjam Künkler, and Amineh Mahallati for their help in making this research and work possible.

References

Abrahamian, Ervand, Iran Between Two Revolutions. Princeton, NJ: Princeton University Press, 1982.Google Scholar
Afary, Janet, Mostofi, Khosrow, and Avery, Peter William. “The Iran–Iraq War (1980–88).” In Iran. Encyclopædia Britannica, May 2019. https://www.britannica.com/place/Iran/The-Islamic-republicGoogle Scholar
Arjomand, Said Amir, Turban for the Crown: The Islamic Revolution in Iran. New York: Oxford University Press, 1988.Google Scholar
Bashiriyeh, Hossein, The State and Revolution in Iran. London: Croom Helm, 1984.Google Scholar
Behrouzan, Orkideh, Prozak Diaries: Psychiatry and Generational Memory in Iran. Stanford, CA: Stanford University Press, 2016.CrossRefGoogle Scholar
Couper, Ian, “Medicine in Iran: A Brief Overview.” South Africa Family Practice 46, no. 5 (2004): 57. doi: 10.1080/20786204.2004.10873077CrossRefGoogle Scholar
Couper, Ian, “Rural Primary Health Care in Iran.” South Africa Family Practice 46, no. 5 (2004): 3739. doi: 10.1080/20786204.2004.10873085CrossRefGoogle Scholar
Dejman, Masoumeh, “Cultural Explanatory Model of Depression among Iranian Women in Three Ethnic Groups (Fars, Kurds and Turks)a.” PhD diss., Karolinska Institutet, 2010.Google Scholar
Deanne, Susannah, “From Sadness to Madness: Tibetan Perspectives on the Causation and Treatment of Psychiatric Illness.” Religions 5, no. 2(May 15, 2014): 444–58. doi:10.3390/rel5020444Google Scholar
Gheissari, Ali, and Nasr, Vali, Democracy in Iran: History and the Quest for Liberty. Oxford: Oxford University Press, 2006. doi: 10.1093/0195189671.001.0001CrossRefGoogle Scholar
Good, Bryon, “The Heart of What’s the Matter: The Semantics of Illness in Iran.” Culture, Medicine, and Psychiatry 1, no. 1 (1977): 2558. doi: 10.1007/BF00114809CrossRefGoogle ScholarPubMed
Good, Bryon, and Kleinman, Arthur. “Culture and Depression.” Epilogue in Culture and Depression: Studies in the Anthropology and Cross-Cultural Psychiatry of Affect and Disorder. Berkeley: University of California Press, 1985: 429505.Google Scholar
Institute for Health Metrics and Evaluation, “Country Profile: Iran.” University of Washington. http://www.healthdata.org/iranGoogle Scholar
Javanbakht, Arash, and Sanati, Mohammad. “Psychiatry and Psychoanalysis in Iran.” Journal of the American Academy of Psychoanalysis and Dynamic Psychiatry 34, no. 3 (January 2006): 405414. doi: 10.1521/jaap.2006.34.3.405Google Scholar
Javanparast, Sara, Baum, Fran, Labonte, Ronald, Sanders, David, Heidari, Gholamreza, and Rezaie, Sakineh. “A Policy Review of the Community Health Worker Programme in Iran.” Journal of Public Health Policy 32, no. 2 (May 2011): 263276. doi: 10.1057/jphp.2011.7CrossRefGoogle ScholarPubMed
Khadivi, Reza, Shakeri, Mostaffa, and Ghobadi, Shamin. “The Efficiency of Mental Health Integration in Primary Health Care: A Ten-Year Study.” International Journal of Preventive Medicine 3, Suppl. 1 (March 2012): S139S145. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3399293/Google ScholarPubMed
Kurzman, Charles, “Death Tolls of the Iran–Iraq War.” October 31,2013. https://kurzman.unc.edu/death-tolls-of-the-iran-iraq-war/Google Scholar
Malekafzali, Hossein.Primary Health Care in the Rural Area of the Islamic Republic of Iran.” Iranian Journal of Public Health 38, Suppl. 1(March 15, 2009): 69–70.Google Scholar
Mansouri, Naghmeh, Gharaee, Banafsheh, Shariat, Seyed Vahid, Bolhari, Jafar, Nooraie, Reza Yousefi, Rahimi-Movaghar, Afarin, and Alirezaie, Narges. “The Change in Attitude and Knowledge of Health Care Personnel and General Population Following Trainings Provided During Integration of Mental Health in Primary Health Care in Iran: A Systematic Review.” International Journal of Mental Health Systems 3, no. 1 (January 2009). doi: 10.1186/1752-4458-3-15CrossRefGoogle Scholar
Maturo, Antonio, “Medicalization: Current Concept and Future Directions in a Bionic Society.” Sociology and Biomedicine 10, no. 1 (2012): 122133. doi: 10.4103/0973-1229.91587Google Scholar
Mehryar, Amir, “Primary Health Care and the Rural Poor in the Islamic Republic of Iran.” A Case Study from Scaling Up Poverty Reduction: A Global Learning Process and Conference, Shanghai, May 25–27, 2004. http://documents.worldbank.org/curated/en/605341468772180275/Primary-health-care-and-the-rural-poor-in-the-Islamic-Republic-of-IranGoogle Scholar
Mental Health Liaison Group. Responding to the Mental Health Needs of Americans: A Briefing Document for Candidates and Policymakers. Washington, DC: Mental Health Liaison Group, 2000.Google Scholar
Mohammadi, Mohammad-Reza, Ghanizadeh, Ahmad, Davidian, Harutiun, Noorbala, Ahamd Ali, Malekafzali, Hossein, Naghavi, Hamid Reza, Pouretemad, Hamid Reza, Yazdi, S. Abbas Bagheri, Rahgozar, Mehdi, Alaghebandrad, Javad, Amini, Homayoun, Razzaghi, Emran Mohammad, Mesgarpour, Bita, Mohammadi, Mohammad, Ghaemi, S. Nasir. “Prevalence of Mood Disorders in Iran.” Iran Journal of Psychiatry 1, no. 2 (2006): 5964.Google Scholar
Mohit, Ahmad, “A Brief Overview of the Development of Mental Health in Iran, Present Challenges and the Road Ahead.” Iranian Journal of Psychiatry and Behavioral Sciences 3, no. 2 (July 2009): 13. http://irisweb.ir/files/site1/rds_journals/76/article-76-39555.pdfGoogle Scholar
Mohit, Ahmad, “Lessons Learned in the Eastern Mediterranean Region from Integration of Mental Health Within Primary Health Care in I.R. Iran.” Paper presented at Meeting of Interested Parties at WHO HQ, Geneva, June 2000.Google Scholar
Naghavi, Mohsen, Abolhassani, Farid, Pourmalek, Farshad, Lakeh, Moradi, Jafari, Nahid, Vaseghi, Sanaz, Hezaveh, Niloufar Mahdavi, and Kazemeini, Hossein. “The Burden of Disease and Injury in Iran 2003.” Population Health Metrics 7, no. 9 (January 2009). doi: 10.1186/1478-7954-7-9CrossRefGoogle Scholar
Noorbala, Ahmad Ali, Bagheri Yazdi, Seyed Abbas, Lari, Mohsen Asadi, and Vaez Mahdavi, Mohammad Reza. “Vazʿīat Salāmat Ravān Āfrād 15 Sālih Va Bālātari Shahr Tihrān Dar Sāli 1387 [Mental health status of individuals fifteen years and older in Tehran, Iran (2009)].” Iranian Journal of Psychiatry and Clinical Psychology 16, no. 4 (2011): 479483. http://ijpcp.iums.ac.ir/browse.php?a_id=1212&sid=1&slc%20Google Scholar
Noorbala, Ahmad Ali, Bagheri Yazdi, S. A., Yasamy, M. T., and Mohammad, K.Mental Health Survey of the Adult Population in Iran.” British Journal of Psychiatry 184, no. 1 (January 2004): 7073. doi: 10.1192/bjp.184.1.70CrossRefGoogle Scholar
Ronaghy, Hossain A., and Solter, Steven L.The Auxiliary Health Worker in Iran.” Lancet 302, no. 7826 (1973): 427429. doi: 10.1016/S0140-6736(73)92284-8Google Scholar
Seifsafari, Shekoofeh, Firoozabadi, Ali, Ghanizadeh, Ahmad, and Salehi, Alireza. “A Symptom Profile Analysis of Depression in a Sample of Iranian Patients.” Iranian Journal of Medical Science 38, no. 1 (March 2013): 2229.Google Scholar
Sen, Amartya, Development as Freedom. New York: Knopf, 1999.Google Scholar
Shadpour, Kamel, “Primary Health Care Networks in the Islamic Republic of Iran.” La Revue De Santé De La Méditerranée Orientale 6, no. 4 (2000): 822825. http://www.emro.who.int/emhj/0604/emhj_2000_6_4_822_825.pdf?ua=1Google ScholarPubMed
Shadpour, Kamel, and Shadpour, Pejman. Networking Primary Health Care: Mississippi Discovers the Iranian System. Ed. Miller, James. Oxford, MS: Oxford International Development Group, 2015. http://www.oidg.org/assets/NetworkingPHC.pdfGoogle Scholar
Steinforth, Arne S., “Whose Madness? Diverging Manifestations of Mental Illness in Dialogue.” Curare 32, no. 1–2 (2009): 96105.Google Scholar
Teimourian, Hazhir 1988. “Murdered Ex-Minister Was Victim of Iran Power Feud; Dr Kazem Sami.” The Times, November 30. https://advance.lexis.com/api/document?collection=news&id=urn:contentItem:41BB-V880-00YJ-Y0YK-00000-00&context=1516831Google Scholar
World Health Organization. “Cuba’s Primary Health Care Revolution: 30 Years On.” https://www.who.int/bulletin/volumes/86/5/08-030508/en/Google Scholar
World Health Organization. “Declaration of Alma-Ata.” Declaration made at International Conference on Primary Health Care, Alma-Ata, USSR, September 6–12, 1978. https://www.who.int/publications/almaata_declaration_en.pdfGoogle Scholar
World Health Organization. “Iran: Nationwide Integration of Mental Health into Primary Care.” In Integrating Mental Health into Primary Care: A Global Perspective, 125134. Geneva: WHO Press, 2008. https://www.who.int/mental_health/policy/services/Iran.pdfGoogle Scholar
World Health Organization. “Metrics: Disability-Adjusted Life Year (DALY).” https://www.who.int/healthinfo/global_burden_disease/estimates/en/index2.htmlGoogle Scholar
World Health Organization. The World Health Report 2001: Mental Health: New Understanding, New Hope. Geneva: World Health Organization, 2001. https://www.who.int/whr/2001/en/Google Scholar
World Health Organization. “WHO-AIMS Report on Mental Health System in the Islamic Republic of Iran.” World Health Organization and Ministry of Health and Medical education, Tehran, 2006. https://www.who.int/mental_health/evidence/who_aims_report_iran.pdfGoogle Scholar
Underwood, Carol, “Child Health under Revolutionary Regimes: The Case of the Islamic Republic of Iran.” PhD diss., Johns Hopkins University, 1993.Google Scholar
Yasamy, M.T., Shahmohammadi, D., Bagheri Yazdi, S.A., Layeghi, H., Bolhari, J., Razzaghi, E.M., Bina, M., and Mohit, A.Mental Health in the Islamic Republic of Iran: Achievements and Areas of Need.” Eastern Mediterranean Health Journal 7, no. 3 (2001): 381391. http://applications.emro.who.int/emhj/0703/emhj_2001_7_3_381_391.pdf?ua=1Google Scholar