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Gaps in treatment can lead to more frequent psychiatric episodes.
Gaps in treatment can lead to more frequent psychiatric episodes.

Frustrating Lack of Mental Health Legislation

The greatest challenge faced by mental health patients is the lack of centers that help with diagnosis, treatment and continuous caring

Frustrating Lack of Mental Health Legislation

Absence of laws related to mental health that uphold the rights of those suffering from mental conditions has made life more difficult for both patients and their families.
The shortcoming has been a matter of discussion for years but it was only last year that Ahmad Hajebi, director of the Mental and Social Health and Addiction Dept. at the Health Ministry, said that a bill relevant to the issue had been submitted to the Majlis Social Commission.
It purportedly addresses their right to have a job, caring and treatment process and the rights of the patients’ families.
Ali Asadi, a deputy at the department, told ISNA on Saturday that the bill is being reviewed by the commission and lawmakers are revising some of the articles.
“The framework of the bill has been accepted and it is undergoing some changes,” he said, adding that the law will include articles on insurance coverage and support for the families and medical staff.
For now, however, the legal vacuum has put patients and their families through hard times.

  Challenges
The greatest challenge is the lack of centers that help with diagnosis, treatment and continuous caring of patients, according to Leila Mohammadi, member of the board of directors of the Iranian Society Supporting Individuals with Schizophrenia.  
“Aside from the Health Ministry, the only other body active in helping the mentally challenged is the State Welfare Organization, which offers affordable in-patient treatment to the people under its coverage,” she said. “There is no other (state or affiliated) organization where those suffering from mental disorders can approach for free and continuous psychiatric services.”
Even the SWO does not offer continuous care and only does it for a limited  period once a year per patient. This is while gaps in treatment can exacerbate the problem and patients could suffer from more frequent psychiatric episodes.
“These people suffer chronic disorders and it is essential to establish a network under which the medical staff pursues the case if a patient, for whatever reason, cannot visit the centers to complete the treatment,” Mohammadi said.
An organized system will help reduce both the frequency of episodes and cost of treatment.
She voiced dismay about the lack of efficient rehab and caring facilities for the mentally ill and the fact that the bulk of the responsibility is on the patients’ families who are not trained and ill-prepared to deal with the problem.
“This will not only deprive family members of living their own lives, but will also leave patients exposed to household violence and domestic abuse since the relatives’ patience can run out,” she noted, calling for laws that will ease the burden on families.
Oftentimes mental disorders are diagnosed too late and after the patient has already formed a family of his/her own and has become a parent. This may put their children at risk.  
Another critical issue is the transfer of patients to medical centers in emergency situations, when their condition becomes severe.
“Families are too scared to take the patient out, the social emergency services hotline (123) only agrees to send an ambulance in the presence of police officers. Hospital emergency staff may refuse to perform the task out of concern for their own safety,” she said.
Even mental hospitals bear no responsibility toward transferring the patient.
“This is largely due to lack of facilities and specific laws that define the responsibility of relevant organizations,” Mohammadi complained.
She was of the opinion that the development of outpatient and home treatment facilities will help address many challenges.
There are only two outpatient facilities in Iran, both in Tehran. The SWO and the Health Ministry offer limited low-cost services and several private clinics provide treatment but at exorbitant rates.

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