The Community Action Program Works to Improve Mental Health at the District Level: The Evaluation of the Community Action Program in Districts of Iran

Three categories of interventions are considered for reducing the prevalence of mental disorders in Iran: mental health promotion, increasing mental health and social service utilization and controlling mental health risk factors. In this regard, we designed a community action program in a national plan to provide comprehensive social and mental health services(SERAJ) that were implemented as a pilot in threedistricts of Iran: Bardasir, Oslo, and Quchan.In this study, we have reviewedthe results of this pilot project.

This study was conducted based on the collaborative evaluation model; first, the program was described and the evaluation indicators of each component of the program were determined. Stakeholders were determined;also, data were collected through literature review, semi-structured interview, and focused group discussion and were analyzed by thematic analysis methods.

The community action program consists of fourcomponents: A Memorandum of Understanding(MoU) between the departments of the districts, People’s Participation House(PPH), Self-reliance Unit(SRU), and actions taken for stigma reduction. A total of 48% of the actions set out in the threeMoU of threedistricts have been executed. The PPH was formed in all threedistricts. A total of 816 social referrals were admitted to SRU for which a self-reliance process has been initiated. Moreover, 47% of referrals have received services and at least 10 messages for stigma reduction and promoting mental disorders have been sent from different sources at the district level.

Strengthening vertical cooperation between the national and provincial levels is essential for the full implementation of the Memorandum of Understanding(MoU) and self-reliance processes. Referring individuals for receiving social support with collaboration between the primary and secondary programs reported to be successful, but feedback to the primary and secondary levels which provides basic and specialized services, is nottransparent. Therefore, we suggest an electronic system as an option to solve this problem. The careful selection of representatives of the people's network and empowerment of PPH and directors of the district on community action skills are essential. Theexperiences of the governors and chairs of health networks of the threedistricts should be presented at a national conference