Widespread collapse, glimpses of revival: a scoping review of mental health policy and service development in Central Asia
Aliev A.-A. Roberts T. Magzumova S. Panteleeva L. Yeshimbetova S. Krupchanka D. Sartorius N. Thornicroft G. Winkler P.
August 2021Springer Science and Business Media Deutschland GmbH
Social Psychiatry and Psychiatric Epidemiology
2021#56Issue 81329 - 1340 pp.
Purpose: We aimed to map evidence on the development of mental health care in Central Asia after 1991. Method: We conducted a scoping review complemented by an expert review. We searched five databases for peer-reviewed journal articles and conducted grey literature searching. The reference lists of included articles were screened for additional relevant publications. Results: We included 53 articles (Kazakhstan: 13, Kyrgyzstan: 14, Tajikistan: 10, Uzbekistan: 9, Turkmenistan: 2, Multinational: 5). Only 9 were published in internationally recognised journals. In the 1990’s mental health services collapsed following a sharp decline in funding, and historically popular folk services re-emerged as an alternative. Currently, modernised mental health policies exist but remain largely unimplemented due to lack of investment and low prioritisation by governments. Psychiatric treatment is still concentrated in hospitals, and community-based and psycho-social services are almost entirely unavailable. Stigma is reportedly high throughout the region, psychiatric myths are widespread, and societal awareness of human rights is low. With the exception of Kyrgyzstan, user involvement is virtually absent. After many years of stagnation, however, political interest in mental health is beginning to show, along with some promising service developments. Conclusions: There is a substantial knowledge gap in the region. Informed decision-making and collaboration with stakeholders is necessary to facilitate future reform implementation.
Central Asia , Deinstitutionalization , Mental health
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Department of Public Mental Health, National Institute of Mental Health, Topolová 748, Klecany, 256 01, Czech Republic
Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
Centre for Society and Mental Health, King’s College London, London, United Kingdom
Department of Psychiatry and Narcology, Tashkent Medical Academy, Tashkent, Uzbekistan
Department of Medical Psychology, Psychiatry and Psychotherapy, Kyrgyz-Russian Slavic University Named After B. N. Yeltsin, Bishkek, Chuy Province, Kyrgyzstan
Department of Psychiatry, Narcology and Neurology, Kazakh-Russian Medical University, Almaty, Kazakhstan
Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
Association for the Improvement of Mental Health Programmes, CH, Geneva, Switzerland
Centre for Global Mental Health and Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
Department of Public Mental Health
Health Service and Population Research Department
Centre for Society and Mental Health
Department of Psychiatry and Narcology
Department of Medical Psychology
Department of Psychiatry
Department of Mental Health and Substance Use
Association for the Improvement of Mental Health Programmes
Centre for Global Mental Health and Centre for Implementation Science
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