Factors affecting the development of mental health insurance in Iran

Extended Abstract 1.Introduction Mental health is one of the important axes of health assessment of different communities so that experts attach great importance to the issue of mental health of people, especially young people and believe that the desired mental health can be directly and indirectly affected by various factors (2) . In fact, mental health is a state of successful functioning of mental processes, efficient activity, effective and fruitful relationships with people, the ability to adapt to change and adapt to favorable conditions. Which is influenced by many factors in addition to individual, biological, genetic and biological characteristics as well as the conditions in which the person grows up, including occupational factors, group factors, organizational factors, conflicts between Work and life, general job satisfaction, job culture satisfaction, income satisfaction and satisfaction with relationships with colleagues, non-observance of justice, lack of flourishing opportunities for individuals and the existence of irrational discrimination (3). If appropriate mental health policies are designed and implemented. It will have a significant impact on the mental health of the community (5). Existence of a strong and efficient insurance system in economic and social empowerment and expansion of opportunities and the right to choose as components of development, can play a fundamental and decisive role in the country. An important part of governmentschr(chr('39')39chr('39')) extensive efforts in the field of health, and accordingly, the World Health Organization, in cooperation with the World Labor Organization in the United Nations, has begun to help countries in these countries comprehensive social security coverage, including a variety of protection problems Financially, develop different ways of substituting income and social support in times of illness (8). In this regard, Iran is no exception to this rule and the issue of health and its promotion has always been one of the main challenges of the government (6). Despite the important functions of mental health insurance, this industry in our country, like most developing countries, remains unknown and its role in the countrychr(chr('39')39chr('39'))s economy and household life is negligible. Because not only the general public but also the financial and economic policy makers of the country are unaware of the benefits associated with it. Also, unfortunately, little research has been done on mental health insurance. In this research, the factors that are effective in the development of this insurance in the country are examined in order to help those in charge of life insurance to take positive steps to expand it in the country. Therefore, the researcher seeks to answer the question of what are the factors affecting the development of mental health insurance in Iran? 2.Methods This research was conducted in two stages: qualitative and quantitative. In terms of purpose, this research is exploratory in the qualitative phase and explanatory in the quantitative phase. The statistical population of the present study in the stage of determining the conceptual model (qualitative phase) included experts, professors, managers and executives of the countrychr(chr('39')39chr('39'))s insurance system that 13 people were selected for interview by snowball method. Based on the existing theoretical foundations of Persian and English, the factors affecting the development of mental health insurance were identified and provided to experts, then, in face-to-face meetings, these factors were discussed, corrected and finally, the factors The final was provided to the experts to express their views on the face validity and content of the factors and items related to each factor. Finally, 34 items with a five-point Likert scale (very low to very high) were approved in the form of four structural, cultural, supply, and individual factors. The statistical population in the quantitative sector (exploratory and confirmatory factor analysis) were managers and employees working in the field of health insurance, health insurance, insurance companies, areas active in the field of health insurance and faculty members in the field of psychiatry. After compiling the questionnaire, the questionnaires were given to a statistical sample of 325 people in various ways such as sending e-mail, face-to-face referral, sending fax, etc. The number of 308 questionnaires was provided to the researcher in full and without any problem for analysis. Data analysis: Extensive factor analysis in SPSS software version 26 was used to identify the factors and confirmatory factor analysis in LISREL software version 9.3 was used to confirm the final model. 3.Results The results of exploratory and confirmatory factor analysis of five basic factors including the first factor (structural); The second factor (culture); 18 Third factor (quality of service); Identified the fourth factor (individual) and the fifth factor (supply and support) for the development of mental health insurance (Table 1-3). 4.Discussion The results of this study showed that 5 structural factors, culture, service quality, individual, supply and support have an important role in the development of mental health insurance. The results of this research in identifying structural factors and financing and services are consistent with the research of Alizadeh et al. (2017), but are not consistent in cultural and personal dimensions (11). The service quality factor included access to professional services, segregation of services according to the type of mental disorders, provision of pharmaceutical and laboratory services. In the cultural factor, socio-cultural changes, fear of stigma, positive attitude towards health insurance, familiarity with different types of insurance and cultural priorities were the decisive items. In the field of individual factors, we can also mention the level of education, income, number of children, understanding the vital role of insurance in providing costs and satisfaction of individuals. Finally, the supply and support agents included the insurerchr(chr('39')39chr('39'))s commitment and guarantee items, the payment of deductibles, NGO grants, and public tax financing. Due to the fact that the insurer is required to fulfill the obligation and guarantee of the insurer towards the insurers, therefore, the insurance operation is delicate and complex and its correct implementation requires the optimal use of statistical, legal, financial, economic, and statistical knowledge. Insurance is investment, marketing and management (14). Finally, identifying important and practical variables in providing health services coverage and their application in the mental health system can help improve the health indicators related to these services. It seems that policy makers in the field of insurance together with companies or insurance systems can rely on education, financial support and services, formulate laws and regulations, familiarize the community with the types of insurance and the need for health insurance, culture and appropriate insurance coverage. Not only will they provide the comfort and well-being of people in the community, but they will also provide adequate financial capital to insurance systems. Ethical Considerations Compliance with ethical guidelines All ethical principles were considered in this article. In order to observe the ethical points in the truth, the researcher undertook to keep all the information in the questionnaire confidential. It also provides the results of the research to the respondents. Funding This research did not receive any specific grant from funding agencies in the public, commercial, or not-for profit sectors. Conflicts of interest The authors declared no conflict of interest