Child and Adolescent Mental Health Care in Iran: Current Status and Future Directions.

BACKGROUND The need for mental health care among children and adolescents in Iran, as in other low and middle income countries (LAMIC) remains mostly unmet. In this paper, we sought to provide an overview of the extent of unmet need and mental health services in Iran. We also aimed to propose approaches to address this gap. METHOD We reviewed the published epidemiologic studies of child and adolescent mental and behavioral health problems in Iran. We also examined the current status of child mental health services and the gaps between current needs and available services based on published literature that included papers published in scientific journals, as well as governmental and other administrative reports. The contextual issues relevant to child mental health care were also explored, as well as the possibilities to introduce new or scale up promising services. RESULTS Child and adolescent mental and behavioral health problems are highly prevalent in Iran. Different studies have estimated that 16.7% to 36.4% of children and adolescents suffer from one or more mental health problems. However, there is a serious scarcity of resources to meet this need. Available services are delivered by independent public organizations (e.g., Ministry of Health, Welfare Organization, and Ministry of Education) or private sector with inefficient communication and collaboration among them and no mandatory national mental health policy. Available specialized child and adolescent services are mostly confined to small inpatient units and university outpatient facilities in larger cities, and there is a scarce evidence for  the effectiveness of the available services. CONCLUSIONS Expansion of primary care's role in timely detection and management of child and adolescent mental health problems, implementation of task-shifting and -sharing initiatives, as well as improved collaboration among responsible governmental and non-governmental sectors are some of the most promising future venues to improve mental health care for the Iranian youth.