Epidemiological aspects of individuals with mental disorders in the referral system: the experience of a Community Mental Health Center in the northeast of Iran

Abstract

Abstract Background Community Mental Health Centers (CMHCs) provide mental health services to patients at low cost, with less stigma, in a domiciliary setting. This study aimed to assess the epidemiological and variety of mental disorders and treatment dropout among patients attending the only CMHC of Mashhad, northeastern Iran. Furthermore, the association of demographic variables with referral from primary health care centers was investigated. Methods This cross-sectional study enrolled 662 patients who contacted this center between January 2014 and December 2021. We completed a checklist that included information on demographics, diagnosed mental disorders, referral status, and the number of psychiatric visits, all of which psychiatrists fully completed clinical records. The frequency distributions of all variables were conducted with SPSS11.5. In addition, the association between epidemiological findings and patient referral (referral system or self-referral) and the association between epidemiological findings and the number of psychiatric revisits were examined by the Chi-square test. Results Of 662 patients, 472 (71%) women and 190 (29%) men were enrolled, and the mean age of all patients was 29 years. Among the 475 adult patients, 367 (77.3%) patients were married and had primary or secondary education (40.4%), and the majority of them were housewives (56.4%). Major Depression Disorder (32%), Generalized Anxiety Disorder (18.3%) were the two most common mental illnesses in patients. Most patients (70.7%) were referred to this center via the referral system. Moreover, non-working patients (housewives and unemployed patients) and the female gender were associated with more referrals to this center through the referral system. 431 patients (65.1%) did not return for a second visit, and the higher number of psychiatric visits was associated with a lower level of education. Conclusions It is recommended that primary health care centers (PHCs) undergo certain modifications to enhance the screening process for psychiatric patients, focusing on common mental disorders. Referral of mental illnesses to CMHCs should be taken more seriously, especially in women with low socioeconomic status. Better health services in CMHCs can encourage patients to continue treatment in CMHCs.