Community mental health services in Türkiye: A qualitative study

Abstract

Studies on community mental health in Türkiye focus more on detecting pathology and incidence, and focus less on preventive community mental health services. The aim of this study to carry out the situation analysis of studies and services on community mental health in Türkiye and to identify existing problems and suggestions. Qualitative methods were used in two stages in the study. In the first stage, studies on community mental health in Türkiye and institutions and organizations related to community mental health services in Türkiye between 2000 and 2022 were analyzed using the mapping method. In the second phase of the research, in-depth interviews were conducted with key informants identified as a result of mapping (10 people out of 24 who could be reached). In addition, 11 more people suggested by key informants were interviewed using the snowball technique, and a total of 21 in-depth interviews were conducted. All interviews were conducted with a semi-structured form, voice recordings were made with the consent of the individuals, and the voice recordings were converted into text before analysis. Thematic content analysis method was used to analyze the interviews. The reliability of the research was ensured by triangulation and its validity by participant confirmation. There are 195 Community Mental Health Centers (CMHC) in Türkiye as of 2022. Although the services here provide some positive results, they are not sufficient, especially in terms of service quality, planning, organization, manpower and financing, and need to be improved. According to the research data, the main 7 themes that emerged were determined as manpower, organization, financing, legislation, policy, service quality and service development. Attention was also drawn to the inadequacies in legislation and health policies. The failure to develop CMHCs, registration problems, case management problems and the failure to eliminate differences between CMHCs are frequently mentioned by key informants. Deficiencies regarding accessibility and inclusiveness of services, and especially manpower shortage, have frequently come to the fore. In addition, it has been determined that community mental health services should not be hospital-based and that the service should be strengthened with mechanisms such as day care and social support. Preventive services in the field of community mental health should not be ignored. Community-based research and projects should be supported more in order to raise public opinion about mental health.