Evidence map›Paper›PMID 31249613›Full record

ArticleInternational journal of mental health systems2019

Assessing the need for a mental health services reform in Moldova: a situation analysis.

Marjonneke de Vetten-Mc Mahon, Laura S Shields-Zeeman, Ionela Petrea, Niek S Klazinga

Abstract read
In one paragraph

Article in International journal of mental health systems, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Marjonneke de Vetten-Mc Mahon1Department Trimbos International, Trimbos, Da Costakade 45, Utrecht, The Netherlands.ORCID 0000-0001-5216-4419
Laura S Shields-Zeeman1Department Trimbos International, Trimbos, Da Costakade 45, Utrecht, The Netherlands.
Ionela Petrea1Department Trimbos International, Trimbos, Da Costakade 45, Utrecht, The Netherlands.
Niek S Klazinga2Department Social Medicine, Academic Medical Centre (AMC), University of Amsterdam (UVA), Meibergdreef 9, Amsterdam, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThis study describes the Moldovan mental health system and reform needs before and during the initial phase of the MENSANA project (2014-2022) over the period 2007-2017.

methodsA situation analysis was performed on: (1) the comparative need based on a country comparison using publicly available mental health system data; (2) the normative need based on a document review comparing the Moldovan mental health services structure with the norms of the WHO on the ideal mix of services, and a content analysis of interview and survey data from professionals (n = 93); (3) the felt need based on a content analysis of survey data from service users and carers (n = 52).

resultsThe main finding from the comparative analysis is that mental health care remains largely institutionalized with little alternative care options in the community. Moldova has large mental hospitals and a high number of psychiatric beds per 100.000 population (59.8) in comparison with the South-eastern European Health Network and EU15 average in 2014 (47.63 and 36.61). The country also shows an inversion of the ideal mix of services. This points to the potential need for a mental health system reform which was confirmed by the perspectives of the professionals, service users and carers. The majority of respondents favour a mental services reform (82.8% of the professionals and 92.3% of the care recipients) and express numerous issues and reform needs with the most frequently mentioned being the need to: (1) reintegrate service users in society, community and family; (2) deinstitutionalise and implement CBMHS; (3) improve the accessibility and quality of services, and; and 4) address health workforce issues.

conclusionAll three types of need explored in the situation analysis (e.g. comparative, normative and felt) point towards the necessity to reform the mental health system in Moldova. However, it is emphasized that this will only materialize when underlying socio-economic challenges that both constrain the implementation of community-based mental health services and foster the dependence of people with a mental illness on inpatient services are addressed.

Indexed as

Central and eastern EuropeCommunity-based mental health servicesFormer Soviet UnionLow-and middle-income countryMental healthNeeds assessmentServices reformSituational analysis

Identifiers

PMID31249613
PMCPMC6587248

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.