Integrating mental health into primary care in Arkhangelsk County, Russia: the Pomor model in psychiatry

Abstract Background Primary health care is still peripheral in the identification and treatment of mental health and substance use disorders in the Russian Federation. However, the development of primary health services has been given priority. A long-standing collaboration between Arkhangelsk Count...

Full description

Bibliographic Details
Published in:International Journal of Mental Health Systems
Main Authors: Grigory Rezvy, Elena Andreeva, Nadezhda Ryzhkova, Vera Yashkovich, Tore Sørlie
Format: Article in Journal/Newspaper
Language:English
Published: BMC 2019
Subjects:
GPs
Online Access:https://doi.org/10.1186/s13033-019-0271-1
https://doaj.org/article/fa28e206a50145899f2ca5cf07dccc15
Description
Summary:Abstract Background Primary health care is still peripheral in the identification and treatment of mental health and substance use disorders in the Russian Federation. However, the development of primary health services has been given priority. A long-standing collaboration between Arkhangelsk County and northern Norway on mental health service development in Arkhangelsk has promoted the integration of mental health into primary care. Aim To develop a model for mental health integration into primary care adapted to the conditions in Arkhangelsk County. Methods (a) Situational assessment, (b) development of a model for systematic cooperation between GPs and specialists, (c) initial evaluation of the model, (d) implementation and dissemination of the model. Results A local studies revealed major shortcomings in GPs’ diagnostic and treatment skills and in their collaboration with specialists in psychiatry. In order to promote better communication between GPs and specialists in this desolate and sparsely populated geographical area, an information communication technology (ICT)-based competence centre was established at a specialised community mental health centre in Arkhangelsk city (APND). Through a network including APND and involved primary health care centres, GPs gained access to specialists’ expertise when required in their work with psychiatric patients. GPs assess all patients’ mental health condition and treatment responsibility for patients in need of mental health care is divided between GPs and specialists according to problem severity. APND has the formal responsibility for ensuring that this collaboration with the health centres is established and practiced. Training in diagnostics and conversation skills ensures basic professional competence in the GPs. Initial evaluation showed that patients, GPs and specialists were satisfied with their experiences. The model is currently under implementation in 50% of the districts of the county. Conclusion Our cooperation has led to the development and ...