Karaoğlan Kahiloğulları Akfer, Alataş Esra, Ertuğrul Fatmagül, Malaj Altin
WHO Country Office Turkey, Ankara, Turkey.
Ministry of Health of Turkey, Ankara, Turkey.
Int J Ment Health Syst. 2020 Nov 11;14(1):84. doi: 10.1186/s13033-020-00416-0.
About 1468 Syrian and Turkish doctors, serving in primary health care, have received the mhGAP training during 2016-2019. As additional training needs were identified, MoH and WHO wanted to understand the usefulness of the training and its impact in responding to the mental health needs of Syrian refugees in Turkey.
A five component assessment was done in 2019, consisting of feedback of trainees, assessment of increase in knowledge; utilization of service; compliance to treatment guidelines and service user satisfaction. The purpose was to understand the perception of participants on the training; estimate the knowledge gained-attributable to the training; estimate the increase in mental health cases identified and treated; compliance with treatment guidelines; as well as perception of the services received by end-beneficiaries.
Results indicate that most of the respondents were happy with the training, but preferred additional mhGAP training as a refresher course in the future. There was knowledge gained due to the training, 9% for the Syrian and 5% for Turkish doctors. The knowledge gained has helped the practicing doctors to be more attentive and increase the numbers of cases diagnosed after the training for almost all groups of diagnoses. Most doctors, observed during practice, comply with the guidelines shared during the training, but improvement is still needed when it comes to prescription and treatment of certain conditions. The average number of mental health cases identified increased by 38 (%27) cases in the year following the training. We observed over 70% compliance with guidelines for 9 out of 12 criteria in question. The results of the patient exit interviews indicate a high level of satisfaction with the MHPSS services provided. About 95% of beneficiaries were happy with the quality of the service, and 92% having their needs met.
The mhGAP training was found useful. More training should be conducted to fill in the gap in service provision and meet the mental needs of Syrian refugees in Turkey.
2016年至2019年期间，约1468名在初级卫生保健领域工作的叙利亚和土耳其医生接受了mhGAP培训。由于确定了额外的培训需求，卫生部和世界卫生组织希望了解该培训的实用性及其在满足土耳其境内叙利亚难民心理健康需求方面的影响。
2019年进行了一项由五个部分组成的评估，包括学员反馈、知识增加评估、服务利用情况、对治疗指南的遵守情况以及服务使用者满意度。目的是了解参与者对培训的看法；估计因培训而获得的知识；估计识别和治疗的心理健康病例的增加；对治疗指南的遵守情况；以及最终受益者对所接受服务的看法。
结果表明，大多数受访者对培训感到满意，但希望未来能有更多的mhGAP培训作为进修课程。培训使知识有所增加，叙利亚医生增加了9%，土耳其医生增加了5%。所获得的知识帮助执业医生更加专注，并增加了几乎所有诊断组培训后诊断出的病例数量。在实践中观察到，大多数医生遵守培训期间分享的指南，但在某些病症的处方和治疗方面仍需改进。培训后的一年中，识别出的心理健康病例平均增加了38例（27%）。我们观察到，在所涉12项标准中的9项上，遵守指南的比例超过70%。患者出院访谈结果表明，对所提供的精神卫生和社会心理支持服务满意度很高。约95%的受益者对服务质量感到满意，92%的受益者需求得到满足。
发现mhGAP培训是有用的。应开展更多培训，以填补服务提供方面的空白，满足土耳其境内叙利亚难民的心理需求。
