Case Finding in Integration of Mental Health Services into Primary Health Care System: Systematic Review of the Studies Conducted in Iran in Recent Two Decades

Objective: This study aims at conducting a systematic review of the researches performed to determine case finding rates throughout the integration of Mental Health Services into PHC over recent twenty years . Method :Through electronic search, major national and international databases including Pubmed, PsychInfo, and EMBase were investigated. All original studies and researches in Persian or English, which had described psychiatric case finding in the PHC, classified as severe and mild mental disorders, epilepsy, mental retardation, and other disorders, were included in the study and were qualitatively assessed. Subsequent to data extraction, heterogeneity test was carried out on all of the studies and each subgroup. Meta-analysis was not applicable as a result of the wide range and heterogeneity of the reported results. Results: Overall, ten studies were included. Case finding rate ranged from 0.07 to 2.04 per thousand for severe mental disorders, 0.5 to 7.6 per thousand for mild mental disorders, 0.5 to 3.9 per thousand for epilepsy, and 0.64 to 3.94 per thousand for mental retardation. Conclusion: Case finding rates reported in the selected studies are highly different from the prevalence of the disorders throughout the country. It seems that the program has been functioning more effectively in case of some of the disorders such as mental retardation, while it has been less efficient in finding mild mental disorder cases. These results reflect the fact that despite its partial achievements in the field of case finding, the integration program is still far from the desirable rates and there is need for revision of its content of the integration program especially screening and diagnostic tools, training contents, and implementation methods.