WONCA Mental Health Consultancy in Moldova

Members of the WONCA Working Party on Mental Health are participating in a major policy initiative to help Moldova move from institutional to community-based mental health care. In collaboration with the European Association for Communication in Healthcare (EACH) and NIVEL in the Netherlands, and with coordination from Trimbos, we are running a series of 'train the trainer' courses. The objective is to equip more than 1000 Moldovan GPs and nurses with essential skills in primary mental health care. Our educational intervention is a key element of a fundamental health care reform programme in Moldova, one of the most economically challenged countries in Europe. The reform programme also involves legislative changes and revisions to the ways in which psychiatric services are delivered - and will also need radical restructuring of pay and conditions for community-based health professionals.

We delivered the first of three training modules at the end of April in Chisinau, the capital of Moldova. There were 20 Moldovan health professionals on the course, a combination of family doctors, nurses and psychiatrists. These are the people who will go on to train primary care teams across Moldova. Evelyn van Weel-Baumgarten led three initial days on communication skills, on behalf of EACH, and then joined me and Dr Sue Martin for two days training on primary mental health care. Under Evelyn's guidance they melded into an effective and cooperative group and by the time Sue and I arrived they were enthusiastic to participate in our module. We covered mental health in context, principles of primary care mental health assessment, risk management (with focus on suicide), assessment of depression and anxiety disorders, and self-help strategies. Immediate group feedback was very positive.

The second module will take place in Utrecht, Netherlands, at the end of May. This will be led by WONCA members Henk Parmentier and Christos Lionis with help from Evelyn and Andre Tylee. It will focus on psychological and pharmacological interventions in primary care, and will give participants opportunity to visit local community mental health and primary care facilities . The third module, due to be held in in Bucharest at the end of July, will be led by myself, Henk and Christos. We plan to cover multi-morbidity and medically unexplained symptoms, the primary care of psychosis and dementia, and an introduction to common mental health problems in children.

We consider this to be a very positive start to WONCA's Primary Mental Health Care Consultancy work. If you would like to know more about it, please contact Christopher Dowrick on [email protected]

Prof Christopher Dowrick

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