Support to the Reform of Mental Health Services in Moldova (MENSANA)

Ministries of Health, of Labour and Social Protection, of Education and of Interior; health and non-health sector professionals providing MH services; National Health Insurance Company and other public funds targeting patients with MH issues; local public authorities; National Employment Agency; relevant civil society organizations / community based organizations (incl. various professional associations and constituency-based organizations).

Final beneficiaries are people with existing MH issues and the general population living in Moldova.

Outcome 1 (service delivery level): The existing network of MH services is able to strengthen and further develop its service provision without support and intermediation of MENSANA.

Outcome 2 (societal level): Population (incl. professionals in various sectors, service users and general population) have increased awareness, literacy and tolerance, promote MH, and support people with MH issues in their recovery and inclusion.

Principaux résultats attendus:  

• The MH system has the knowledge, skills, tools, processes and mechanisms in place to enable all key actors to deliver MH care according to the model of care
• Evidence and insights are available to inform decision-making and policy processes in MH
• The content for MH promotion and prevention programs is developed for different settings (workplaces, care settings, schools) and targeting different age groups (children, youth, adults, older adults)
• Local communities are supported and equipped to be more accepting of people with MH issues and use opportunities for social inclusion and participation of people with MH issues
• Models are developed and tested for supportive employment of people with MH problems

Principaux résultats antérieurs:  

The community-based model of MH care was piloted in phase 1 and, in phase 2, it was rolled out to cover the whole country with a network of 40 Community Mental Healthcare Centres (CMHCs). CMHCs operate within primary health care (PHC) facilities and are contracted by the National Health Insurance Company (NHIC). Currently, NHIC funding for the functioning costs of the CMHCs network amounts to ~ CHF 1.6 million / year. The regulatory framework on the work and roles of MH professionals and CMHCs is in place. Relevant health professionals have been trained to work with people suffering from MH problems. And an interdisciplinary coordination mechanism has been initiated and includes relevant non-health sector services.

The project has supported the shift from centralised and stigmatising hospital care to better coordinated, community-based and patient-centred services, which resulted in rationalization of resources, while making the available services more fit to users’ needs. The unnecessary and preventable hospitalizations of people with MH disorders decreased by ~37%, while the demand for alternative care at the community level among patients, general population, as well as concerned professionals increased.

During the pandemic, the project has become the go-to source for MH information and expertise in the country, which clearly speaks about the high relevance and timeliness of the intervention, both during stable times, and during times of crisis.