A cross-sectional study of service user needs in the Republic of Moldova first step of implementation of mental health reform

Abstract

The Republic of Moldova has been undergoing a comprehensive national reform of its mental health system since 2014 in an effort to deinstitutionalize mental health care. The central aim was to implement a continuum of mental health care provided through family doctors, community mental health care teams and mental health care specialists in acute psychiatric wards and general regional hospitals. The current research was conducted in the context of an ongoing reform of mental health services in the Republic of Moldova since 2014, where efforts have been devoted to creating community-based mental health services. This paper presents a snapshot of the needs of mental health service users in the Republic of Moldova and helps to understand how and with which services their needs can be addressed in line with the triage and care pathway modifications made as part of the ongoing reform of the mental health services in the country. This cross-sectional study compared the levels of needs, quality of life, mental health status and functioning among mental health service users consecutively admitted to the psychiatric hospital in Chisinau, Moldova. All service users resided in one of the project’s pilot districts where community mental health services were being developed. Conclusions – There was a high number of unmet needs among this inpatient population, particularly social needs and service-related needs, which helps to guide future service delivery reform efforts in Moldova. A continuum of inpatient and outpatient care, and individual treatment plans can help address the different needs of different patients. Individual treatment plans for patients, and the choice of the appropriate treatment for patients could be guided successfully by an assessment of service users’ (unmet) needs of care and level of functioning.