Community-Based Mental Health Services in Azerbaijan: a Course Toward Development: Развитие внебольничной психиатрической службы Азербайджана.

Community mental health care in Azerbaijan was established in 2011 in the line with the country's mental health reform. The main directions of the reform, as described in the National Mental Health Strategy, were deinstitutionalization, improving quality of care, integration of mental health into primary healthcare, and implementation of modern community-based services. Over the last decade, the number of beds in psychiatric hospitals has significantly decreased, and many psychiatrists and psychiatric nurses have been transferred to primary care facilities. At the same time, programs focusing on comprehensive care have been implemented in different regions of the country. Community mental health services currently employ various kinds of mental health professional including psychiatrists, clinical psychologists, social workers, occupational therapists, and nurses to ensure a multidisciplinary approach to care provision. Team-based care may focus on crisis resolution, psychosocial rehabilitation, case management, family support, and early intervention for psychosis. Among the barriers preventing development of community mental health services, one should note, in particular, stigma belittling the priority of mental healthcare, uncertainty in distribution of authority between the Ministry of Health and the State Agency for Mandatory Health Insurance, and a general scarcity of human resources, especially in the rural regions. Nevertheless, the mental health care in Azerbaijan is continuing its transition from an institutional model to community-based services.