Health in the news: Who is responsible for patients with chronic mental disorders?

In 2001, provinding healthcare for patients with mental disorders became a responsibility of the Sazemane Behzisti (Welfare Organization)* . According to the Article 97 of the Fourth Development Plan 75% of the target population should be covered during a five-year peiod beginnig from 2005.
Mr. Barati, chair of the committee for reorganizing chronic mental disorders of Sazemane Behzisiti says: over the last 4 decades the absolute number of hospital beds for mental patients has been increasing while the ratio of mental beds to total beds has been on the steady decrease. This ratio has been 10%, 8%, 7%, and 5% for the years 1968, 1973, 1984, and the current year respectively. Now, Sazemane Behzisti with 4200 beds is provinding standard care with patients affecting mental disorders. Barati claims that the MOH through focusing on preventive mental care has been deviated from investment for therapeutic mental care. He reiterates that in order for the people in the MOH to find a solution for problems with mental illnesses in the country they should see and analyze the facts instead of investing time in trasnlating foreign books and articles!
More statistics repoted by Barati:
1-21,100 mental patients are being serviced by Behzisti.
2-Cost per mental bed for Behzisti : 125,000 Tomans
3-Total hostpital beds in the coutnry: 109,000
* Welfare Organization is completely different from Vezarate Refah (formerly Sazemane Tamine Ejtemaei). Now, Iran has different bodies for providing welfare for the people, all acting at national level but are totally independent.

My comment: Well, it's not that easy to comment on this article. Behzisti is a typical example of decentralization of healthcare in Iran at all possible levels (from policymaking to provinding direct care). Reviewing 50 years history of healthcare in Iran, I can say we have had few successful decentralization examples in healthcare. We all know that standard mental wards staffed by university psychiatrists are under the MOH. In order for Sazemane Behzisti to act successfully in providing therapeutic care for patients with mental illnesses it may need to have kind of policies for integration into these wards in one way or another.


Source: Jamejam online: December 27, 2006
Code:4N