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Mental health reform in the Russian Federation: an integrated approach to achieve social inclusion and recovery

By Rachel Jenkins, Stuart Lancashire, David McDaid, Yevgeniy Samyshkin, Samantha Green, Jonathan Watkins, Angelina Potasheva, Alexey Nikiforov, Zinaida Bobylova, Valery Gafurov, David Goldberg, Peter Huxley, Jo Lucas, Nick Purchase and Rifat Atun

Abstract

Objective: To facilitate mental health reform in one Russian oblast (region) using systematic approaches to policy design and implementation. Methods The authors undertook a three-year action-research programme across three pilot sites, comprising a multifaceted set of interventions combining situation appraisal to inform planning, sustained policy dialogue at federal and regional levels to catalyse change, introduction of multidisciplinary and intersectoral-working at all levels, skills-based training for professionals, and support for nongovernmental organizations (NGOs) to develop new care models. Findings Training programmes developed in this process have been adopted into routine curricula with measurable changes in staff skills. Approaches to care improved through multidisciplinary and multisectoral service delivery, with an increase in NGO activities, user involvement in care planning and delivery in all pilot sites. Hospital admissions at start and end of the study fell in two pilot sites, while the rate of readmissions in all three pilot sites by 2006 was below that for the region as a whole. Lessons learned have informed the development of regional and federal mental health policies. Conclusion A multifaceted and comprehensive programme can be effective in overcoming organizational barriers to the introduction of evidence-based multisectoral interventions in one Russian region. This can help facilitate significant and sustainable changes in policy and reduce institutionalization

Topics: HV Social pathology. Social and public welfare. Criminology
Publisher: World Health Organization
Year: 2007
DOI identifier: 10.2471/BLT.06.039156
OAI identifier: oai:eprints.lse.ac.uk:5046
Provided by: LSE Research Online

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Citations

  1. (1996). The global burden of disease. doi
  2. (2003). Investing in mental health. doi
  3. Mental Health Survey Consortium. Prevalence, severity and unmet need for treatment of mental disorders in the World Health Organization World Mental Health Surveys. doi
  4. (2001). World health report 2001. Mental health: new understanding, new hope. doi
  5. (2005). The European health report 2005: public health action for healthier children and populations. Copenhagen: WHO Regional Office for Europe;
  6. Social factors and increase in mortality in Russia in the 1990s: prospective cohort study. doi
  7. (2003). Health expectancy in the Russian Federation: a new perspective on the health divide in Europe. Bull World Health Organ
  8. (2001). Economic reform and mortality in the former Soviet Union: a study of the suicide epidemic in the 1990s. Eur Econ Rev doi
  9. (2001). Alcohol is implicated in the fluctuations in cardiovascular disease in Russia since the 1980s. Ann Epidemiol doi
  10. The health crisis in Russia. doi
  11. (2004). Global burden of disease in 2002: data sources, methods and results.
  12. (2004). DALY estimates for 2002 by cause for WHO Member States.
  13. (2005). Central Asia Human Development Department. Dying too young: addressing premature mortality and ill health due to noncommunicable diseases and injuries in the Russian Federation. Washington: World Bank;
  14. (2004). Suicide rates by country. doi
  15. (2001). Collegium of the Russian Ministry of Health.
  16. the Russian Federation. Decree on the federal target programme ‘Urgent measures for improvement of psychiatric care for the period of 1995-1997’. Moscow: Government of the Russian Federation:
  17. Reflections on the past and current state of Russian psychiatry. doi
  18. (2005). Investing in development: a practical plan to achieve the millennium development goals. doi
  19. Mental health in post-communist countries. doi
  20. (2005). Mental health declaration for Europe: facing the challenges, building solutions. doi
  21. (2005). Mental health action plan for Europe. doi
  22. (2001). Strategies for disseminating evidence-based practices to staff who treat people with serious mental illness. Psychiatr Serv doi
  23. Supporting the application of psychosocial interventions in adult inpatient services.
  24. (1990). Alternative perspectives on action research. Theory Into Practice doi
  25. (1999). Human Relations doi
  26. (1994). Introduction: entering the field of qualitative research.
  27. A framework and toolkit for capturing the communicable disease programmes within health systems: tuberculosis control as an illustrative example. doi
  28. (2005). Analysis of how health system context influences HIV control: case studies from the Russian Federation. Bull World Health Organ
  29. Barriers to sustainable tuberculosis control in the Russian Federation. Bull World Health Organ
  30. (2004). The mental health country profile: background, design and use of a systematic method of appraisal. Int Rev Psychiatry doi
  31. (2000). Management of mental disorders.
  32. (1996). Diagnostic and management guidelines for mental disorders in primary care:
  33. (2002). Developing a national mental health policy. doi
  34. (2004). Russia: mental health reform in the post-Soviet period. In: Morrall P, Hazleton M, eds, Mental health: global policies and human rights.
  35. (2004). On the reform of psychiatric care.
  36. Health for all database. Copenhagen: WHO Regional Office for Europe; doi
  37. (2005). Atlas: mental health resources around the world.
  38. (2003). Health care systems in transition: Russian Federation. Copenhagen: European Observatory on Health Systems and Policies;
  39. Governance in gridlock in the Russian health system: the case of Sverdlovsk oblast. doi
  40. Health system factors impacting on delivery of mental health services in Russia: multi-methods study. doi
  41. (2005). Implementing general practice in Russia: getting beyond the first steps. BMJ doi
  42. (2004). Mental health policy, plans and programmes (updated version).
  43. Moving beyond the mental health care system: an exploration of the interfaces between health and non-health sectors. doi
  44. (2002). Collegium of the Russian Ministry of Health. Sectoral programme of development of reorganisation of the network of psychiatric care in the Russian Federation for the period of 2003-2008. Moscow: Government of the Russian Federation;
  45. Reforming the Russian health-care system. doi
  46. (2005). State of the nation address. Moscow: Federal Assembly of the Russian Federation;
  47. Money for health in Russia, at long last. doi

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