20. Mai 2026

Die folgenden Ausschnitte aus ausgewählten Quellen enthalten Informationen zu oben genannter Fragestellung (Zugriff auf alle Quellen am 20. Mai 2026):

Bitte beachten Sie, dass die in dieser Anfragebeantwortung enthaltenen Übersetzungen aus dem Finnischen mangels Sprachkenntnis unter Verwendung von technischen Übersetzungshilfen erstellt wurden. Es besteht daher ein erhöhtes Risiko, dass diese Arbeitsübersetzungen Ungenauigkeiten enthalten.

Das Center for Human Rights in Iran (CHRI) ist eine 2008 gegründete, in New York (USA) ansässige Non-Profit-Organisation, die Menschenrechtsverletzungen im Iran recherchiert und dokumentiert.

CRHI – Center for Human Rights in Iran: Iranian Law Should Allow People With Disabilities to Make Their Own Legal Decisions, 22. August 2018
https://iranhumanrights.org/2018/08/iranian-law-should-allow-people-with-disabilities-to-make-their-own-legal-decisions/

„Most Iranian citizens with disabilities, especially those with mental or psychological disabilities, are unable to legally control or manage personal matters such as marriage, divorce, parental custody or their property.

Citizens, in general, have ‘legal capacity’ under the principle of ‘equal rights under the law.’ However, the Islamic Republic of Iran’s Civil Code denies legal rights to two groups of citizens who have been categorized as ‘incapacitated.’

People categorized as ‘lunatics’ under Iranian law cannot make legal decisions in any circumstance and those who have been categorized as living with an ‘unsound mind’ are not permitted to make financial decisions.

The ‘unsound mind’ category also excludes people with disabilities from being a witness in a trial, filing a lawsuit, or taking possession of inherited property.

Instead, the law enables their parents or legal guardians to make decisions for them.

According to Article 22 of Iran’s Law for the Protection of the Rights of Persons With Disabilities, judicial authorities are required to appoint a guardian, if necessary, for persons with disabilities after consultations with the State Welfare Organization (SWO). If no qualified person is available, the court will appoint the SWO as legal guardian.” (CRHI, 22 August 2018)

Im Zuge der zeitlich begrenzten Recherche konnten keine weiteren Informationen zur Behandlungs- und Betreuungssituation, speziell nicht geschäftsfähiger oder nicht voll geschäftsfähiger psychisch erkrankter Personen gefunden werden. Im Folgenden finden sich daher Informationen zur Behandlungs- und Betreuungssituation psychisch erkrankter Personen im Allgemeinen.

Das Finnish Immigration Service, eine Einrichtung innerhalb des finnischen Innenministeriums, die für die Entscheidungsfindung im Rahmen von Asylverfahren zuständig ist, schreibt in einer finnischen Anfragebeantwortung von September 2025, dass der Iran über ein nationales Programm für psychische Gesundheit verfüge, das grundlegende Leistungen der psychischen Gesundheitsversorgung in der Primärversorgung im ganzen Land umfasse. Die psychische Gesundheitsversorgung stütze sich einerseits Berichten zufolge größtenteils auf stationäre Behandlungen. Unter Bezugnahme auf eine nicht öffentlich zugängliche Umfrage des MedCOI-Dienstes der Europäischen Asylagentur (EUAA) aus dem Jahr 2025 berichtet der Finnish Immigration Service des Weiteren, in Teheran seien unter anderem die Behandlung von Angststörungen, Depressionen und psychotischen Störungen durch Psychiater·innen und Psycholog·innen im ambulanten und stationären Bereich verfügbar. Darüber hinaus würden in Teheran Psychotherapie, EMDR (Eye Movement Desensitization and Reduction), psychiatrische Unterstützungsdienste und Wohnmöglichkeiten, Unterstützung für Suizidgefährdete sowie gegebenenfalls Zwangseinweisungen angeboten. Laut EUAA seien einige Antipsychotika und Antidepressiva in Teheraner Apotheken erhältlich, jedoch seien manche der benötigten Antipsychotika entweder nicht verfügbar oder müssten aus dem Ausland bestellt werden (Finnish Immigration Service, 11. September 2025, S. 4).

Das iranische Sozialversicherungssystem sei erweitert worden und umfasse nun auch öffentliche psychiatrische Leistungen im Rahmen der Krankenversicherung sowie Zuschüsse für Menschen mit chronischen psychischen Erkrankungen. So müssten beispielsweise stationäre Patient·innen aufgrund der jüngsten Erweiterungen keine Zuzahlung mehr leisten. Laut einer Studie von MedCOI decke die Krankenversicherung je nach Versicherungsart 20–80% der Behandlungs- und Medikamentenkosten in öffentlichen Einrichtungen ab. Die Inanspruchnahme psychiatrischer Leistungen sei relativ gering: Nur ein Drittel der Menschen mit psychischen Erkrankungen erhalte eine Behandlung. Dies werde auf Unwissenheit, Stigmatisierung und Diskriminierung zurückgeführt. Zudem sei der Zugang zu Behandlungen in manchen Gebieten durch große Entfernungen und mögliche Gebühren eingeschränkt (Finnish Immigration Service, 11. September 2025, S. 4-5):

·      Finnish Immigration Service: Iran / Terveydenhuolto ja mielenterveyspalvelut, päivitys 2024–2025; Iran / Healthcare and mental health services, update of 2024–2025 [KT1139], 11. September 2025
https://maatieto.migri.fi/file/download/?type=content&contentId=142850cd-cdbc-4453-a1f4-55010019141b&inline=true&lang=fi

Roya Taheri Mirghaed ist Forscherin am Forschungszentrum für gemeindeorientierte Krankenpflege und Geburtshilfe und Schule für Krankenpflege und Geburtshilfe an der Medizinischen Universität Shahrekord im Iran.

·      Taheri Mirghaed, Roya et al.: Mental Health Policies: Comparative Analysis of Mental Health Systems in Iran and Six Selected Countries, In: Evidence Based Health Policy, Management & Economics, 2025 9(1), 2025, S. 53-64
https://publish.kne-publishing.com/index.php/JEBHPME/article/download/19420/18108/

„In Iran, mental health care services are integrated into primary care. In addition, public hospitals and non-governmental clinics provide mental health care services. […]

The reports show that there are 19 psychiatric hospitals in Norway, 20 in Canada, 5 in Lebanon, 17 in Australia, 39 in Iran, 9 in Turkey, and 2 in Iraq. The highest number of psychiatric beds in a public hospital belongs to Australia with a number of 21.76 per 100000 population. This amount is 4.67 in Turkey, 1.45 in Lebanon, 1.01 in Iraq, 4.66 in Iran […]. Moreover, the number of health care providers (psychiatrists) per 100000 population in the countries was 30.77 in Norway, 13.53 in Australia, 14.7 in Canada, 1.64 in Turkey, 2.02 in Iran […]. Associations for providing support for patients and their families during mental treatment are present in Turkey, Australia, Canada, Norway, and Iran. […] In addition, the number of daycare institutes per 100000 population was 0.12 in Iran […]. Moreover, facilities for outpatient treatment of mental patients per 100000 population was 4.65 in Australia, 3.6 in Norway, 1.43 in Iran […].

Between the countries under study, all but Norway had a policy document on mental health.” (Taheri Mirghaed et al., 2025, S. 57)

„In 2006, mental health policy document of Norway was reviewed, and the same happened in Iran in 2015. The content of mental health document in Iran consists of an integration of mental health programs into primary health care. […] The reports showed that no specific laws are present for mental health in Turkey, Australia, and Norway. However, Iran, Iraq, Canada, and Lebanon have specific laws for mental health care (table 3).” (Taheri Mirghaed et al., 2025, S. 58)

„For instance, in Iran, integration of mental health care plans in primary health care plan, which is totally costless, has limited the need for private insurance in this section. Nevertheless, the presence of private insurance is considered a positive point because it lowers the need for individual payments of the patients which can sometimes be catastrophic. Social insurance is present in Iran, Lebanon, and Turkey. This mechanism integrates the financial support for health issues of their members, and on the other hand, it runs on donations of organizations, families, and government. […]

Iran has a more favorable situation among similar countries in terms of facilities for outpatient mental health care. Research on the pathway of referral of psychiatric patients in the country shows that these patients refer to practitioners and treatment centers first, and a few of patients refer to traditional therapists or alternative therapies. Considering the high prevalence of psychiatric disorders in Iran and the low number of hospital beds, the health care system fails to provide the required services to several patients. […] Iran has 1.14 facilities for outpatient services per 100.000 mental patients.” (Taheri Mirghaed et al., 2025, S. 60)

Der Menschenrechtsrat der Vereinten Nationen (UN Human Rights Council, HRC) ist ein zwischenstaatliches Gremium, das sich für die Förderung und den Schutz der Menschenrechte weltweit einsetzt.

·      HRC – UN Human Rights Council: Situation of human rights in the Islamic Republic of Iran; Report of the Secretary General [A/HRC/56/22], 12. Februar 2025
https://www.ecoi.net/en/file/local/2112079/g2410077.pdf

„The overall economic crisis has significantly impacted the health sector, exacerbating already challenging working conditions for medical staff and negatively affecting people’s enjoyment of the right to the highest attainable standard of physical and mental health. Medical staff face a variety of pressures, including low wages and delayed salary payments. Citing troubling statistics, the President of the Supreme Council of the Medical System has drawn attention to an increase in suicide rates within the medical community due to challenging socioeconomic conditions.“ (HRC, 12. Februar 2025, S. 8)

Die Weltgesundheitsorganisation (WHO), eine Behörde der Vereinten Nationen mit dem Mandat zur Förderung der globalen Gesundheitsagenda, veröffentlicht im September 2025 folgendes Datenblatt zu psychischer Gesundheitsversorgung im Iran für das Jahr 2024:

·      WHO – World Health Organization: Mental Health Atlas 2024; Country profile; Iran (Islamic Republic of), 2. September 2025
https://www.ecoi.net/en/file/local/2136626/iran-(islamic-republic-of).pdf

Saeid Zandi ist wissenschaftlicher Mitarbeiter am Institut für Sozialarbeit und Kriminologie der Fakultät für Gesundheits- und Arbeitswissenschaften der Universität Gävle in Schweden.

·      Zandi, Saeid et al.: Mental Health and Mental Health Care in Iran: Addressing Social Inequalities, 1. Dezember 2025
https://www.researchgate.net/journal/Healthcare-2227-9032/publication/398175895_Mental_Health_and_Mental_Health_Care_in_Iran_Addressing_Social_Inequalities/links/6939b82306a9ab54f845cfa6/Mental-Health-and-Mental-Health-Care-in-Iran-Addressing-Social-Inequalities.pdf?_tp=eyJjb250ZXh0Ijp7ImZpcnN0UGFnZSI6InB1YmxpY2F0aW9uIiwicGFnZSI6InB1YmxpY2F0aW9u·in19

„Iran carries a significant burden of mental health disorders. This study aimed to describe the status of mental health and mental health care in Iran between 2012 and 2023, addressing inequalities and mapping existing challenges in the mental health care system […]

Care and Treatment

A significant number of Iranians with mental disorders, approximately 65.3%, did not receive psychiatric care according to the 2010 National Mental Health Survey (NMHS). Two-thirds of Iranians diagnosed with MHD [mental health disorders] do not receive mental health interventions because the mental health services have been inadequately distributed in Iran. Mental disorders also place a significant financial burden on families in Iran. According to the NMHS, over 30% of a household’s annual income is allocated to psychiatric treatment for a single patient. However, another study suggests that under the new socio-mental services model, these expenses are relatively modest in comparison with Iran’s GDP [Gross Domestic Product] per capita. […]

According to the latest data available, there were 20 mental health workers per 100,000 Iranians in 2017. In 2013, the number of psychiatrists was about 1000, and the number of clinical psychologists was 174. […]

Approximately 53% of the population has access to essential psychotherapeutic medicines free of charge, with a coverage of at least 80%. All mental disorders are covered under the social insurance schemes, with certain limitations on the duration of hospital stays. The incorporation of mental health services into the primary health network represents a significant stride towards the progress and advancement of mental health care services in the country. Despite these strides, the detection rates of mental disorders remain low, and the system falls short of optimal performance, particularly in urban areas where the primary health care (PHC) network is less efficient compared to rural areas and a robust private sector offers patients direct access to specialists and subspecialists.“ (Zandi et al., 1. Dezember 2025, S. 1, 7, 8)

„Primary health care and referrals to specialized levels within Iran’s health system are managed by the public sector. Although approximately 75% of outpatient mental health services in Iran are provided by private clinics, psychologists, and psychiatrists, the private hospitals and private counseling and psychotherapy centers operate independently of this process and do not have a defined role or systematic procedure within the public sector referral system. […] All mental health services within Iran’s primary health care system are free of charge. However, if a general practitioner refers a patient to a hospital-based psychiatrist, the patient is required to pay a fee as determined by the Ministry of Health.” (Zandi et al., 1. Dezember 2025, S. 9)

Das Free Iran Scholars Network (FISN) ist laut Selbstbeschreibung ein säkulares und selbstverwaltetes Netzwerk, das sich für kritisches Denken sowie die Schaffung eines „pluralistischen, säkularen, demokratischen, prosperierenden und republikanischen Iran“ einsetzt und „die globale Einheit unter Wissenschaftlern, Akademikern und Fachleuten“ [Original auf Englisch, Anmerkung ACCORD] fördert.

·      FISN – Free Iran Scholars Network: Crushed Minds, Broken System: Iran’s Mental Health Crisis Under the Islamic Republic (An FISN Research Project), 28. Juni 2025
https://freeiransn.com/crushed-minds-broken-system-irans-mental-health-crisis-under-the-islamic-republic-an-fisn-research-project-2/

„Iran is facing a mental health crisis of staggering proportions. One in four Iranians is currently affected by a diagnosable mental disorder. […] From underfunded psychiatric services to the use of psychiatric institutions for political repression, the Islamic Republic has turned what should be a system of healing into yet another instrument of decay and control. […]

Iran’s mental health infrastructure is grossly inadequate. According to a recent report published in Frontiers in Public Health, the country lacks a cohesive mental health policy, suffers from low government prioritization, and is plagued by fragmentation across services. Access to trained professionals is woefully insufficient. As of 2020, Iran had fewer than 1,000 licensed psychiatrists for a population of over 80 million. In rural and underserved urban areas, mental health services are nearly non-existent.

The problem is not merely one of numbers. There is a complete absence of a coordinated referral system, resulting in patients bouncing between general practitioners, emergency rooms, and spiritual advisors without receiving proper psychiatric care. Furthermore, there is no mandatory continuing education for mental health professionals, meaning that treatment standards are outdated and inconsistent.

Political Weaponization of Psychiatry

Beyond neglect, the regime has actively weaponized psychiatry to punish dissent. Numerous human rights organizations have documented cases where protesters, especially women, are forcibly admitted to psychiatric institutions under the pretense of ‘delusion’ or ‘anti-social behavior.’ In one notorious case, a woman arrested for undressing in public as a protest was forcibly institutionalized, raising alarms from Amnesty International and Human Rights Watch. […]

Mental illness in Iran remains a taboo topic. Cultural stigma leads many families to conceal mental disorders, and many individuals suffer alone. Yet rather than launch public education campaigns or normalize treatment, the regime has reinforced silence. Officials routinely downplay mental health statistics, and clerical authorities often frame mental illness as a spiritual failing or lack of faith.

This cultural suppression is compounded by a lack of legal protection. Iran has no mental health act or legal framework to protect patients’ rights or ensure ethical standards of care. This legal vacuum enables abuse, neglect, and state manipulation of psychiatric institutions without consequence.

Clerics have also undermined scientific medicine by promoting so-called ‘Islamic healing’ as an alternative to professional mental health treatment. State media frequently airs programming that suggests prayer, fasting, and allegiance to the Supreme Leader as cures for depression and anxiety, effectively pathologizing dissent and deflecting from material causes of psychological distress.” (FISN, 28. Juni 2025)

Das Country Policy and Information Team, das Teil jener Abteilung des britischen Innenministeriums (UK Home Office) ist, die für Asyl- und Menschenrechtsfragen zuständig ist und Länderberichte und Richtlinien schreibt, veröffentlicht im Juni 2024 folgende Country Information Note, in der im Kapitel 25 Informationen aus dem nicht öffentlich zugänglichen MedCOI-Portal der Europäischen Asylagentur (EUAA) zur psychischen Gesundheitsversorgung im Iran angeführt werden:

·      UK Home Office: Country Information Note Iran: Healthcare and medical treatment [Version 2.0], Juni 2024
https://www.ecoi.net/en/file/local/2112332/IRN CPIN Medical and healthcare issues__2_.pdf

„Availability of facilities and treatment

25.1.1 The EUAA MedCOI database stated, in a 2020 response to an information request, that psychiatric care for mentally ill people was available, including treatment for PTSD and people at suicide risk, for example, at the Iran Psychiatric Hospital in Tehran. […]

Availability of medication

25.2.1 The EUAA MedCOI database stated that the following drugs, used to treat psychiatric conditions, were available in Iran in 2020 (from pharmacies in Tehran):

• Fluoxetine (anti-depressant)

• Escitalopram (anti-depressant)

• Venlafaxine (anti-depressant)

• Aripiprazole (anti-psychotic)

• Clozapine (anti-psychotic).

25.2.2 The EUAA MedCOI database stated that the following drugs, used to treat psychiatric conditions, were available in Iran in 2020 (from pharmacies in Tehran):

• Risperidone (anti-psychotic)

• Paliperidone (anti-psychotic)

• Clotiapine (anti-psychotic)

• Quetiapine (anti-psychotic)

• Olanzapine (anti-psychotic)

• Duloxetine (anti-depressant)

• Trazodone (anti-depressant)

• Mirtazapine (anti-depressant).

25.2.3 The EUAA MedCOI database stated that the following drugs, used to treat psychiatric conditions, were available in Iran in 2020 (from pharmacies in Tehran):

• Oxazepam (anti-anxiety)

• Lorazepam (anti-anxiety)

• Diazepam (anti-anxiety)

• Citalopram (anti-depressant)

• Sertraline (anti-depressant).„ (UK Home Office, Juni 2024, S. 40 -41)

Auf seiner Webseite führt das oben erwähnte Psychiatrische Krankenhaus in Teheran an, folgende Dienste anzubieten: Psychotherapie, Ketamin-Therapie zur Behandlung von Depressionen, Elektroenzephalografie-Untersuchungen (EEG), transkraniale Magnetstimulation, sowie Elektroschocktherapie (Iranian Hospital, ohne Datum):

·      Iranian Hospital: Iranian Psychiatric Hospital – Neurological and mental speciality hospital (holder of ISO 9001 certificate) – Hospital Services, ohne Datum
https://iranian-hospital.com/

Das Department of Foreign Affairs and Trade (DFAT) ist das Außenministerium Australiens. Sein Ziel ist die Förderung und der Schutz der internationalen Interessen Australiens mit Blick auf die Sicherheit und den Wohlstand des Landes.

·      DFAT – Australian Government - Department of Foreign Affairs and Trade: DFAT Country Information Report Iran, 24. Juli 2023
https://www.ecoi.net/en/file/local/2095685/country-information-report-iran.pdf

„Mental health services are provided as part of the mainstream health services available to all Iranians. However, according to a 2021 study published in the Iranian Journal of Psychiatry, the Iranian Mental Health Survey indicated almost one in four people had one or more psychiatric disorders (23.6 per cent); two-thirds of patients did not benefit from health interventions; and many provided services were inadequate and imposed a high burden on Iranian families. As in many countries, stigma is a significant barrier to seeking treatment. While mental illness has, to date, not been considered a legitimate medical condition, and people living with mental illness have been expected to ‘tough it out’, there are signs that this is changing – at least in the more progressive parts of Iran. Stigma can include difficulties in relationships, prejudicial attitudes including social discrimination, or societal acceptance and approval of such discrimination. Families will typically hide the fact that a member is living with a mental illness and will isolate them socially; families may also physically restrain the individual. Private services are available, especially in Tehran, but are expensive.“ (DFAT, 24. Juli 2023, S. 11)

Die Zentralstelle für Informationsvermittlung zur Rückkehrförderung (ZIRF) ist eine Einrichtung innerhalb des deutschen Bundesamts für Migration und Flüchtlinge (BAMF), deren Aufgabe es ist, durch Informationen und Beratung die freiwillige Rückkehr von Asylbewerber·innen zu vereinfachen und zu fördern.

·      ZIRF – Zentralstelle für Informationsvermittlung zur Rückkehrförderung: Iran - Country Fact Sheet 2022, Juli 2022
https://iompwesagerrfg001.blob.core.windows.net/rfg/CFS_2022_Iran_EN.pdf

„Since there is no agreed definition for vulnerability, it is not possible to list the vulnerable groups, but there are public and private organizations as well as NGOs which are providing specialized services for their defined target groups. Generally, there are two types of centres providing services to the vulnerable groups in Iran - public and private ones. Public centres are normally overpopulated with long queues. The beneficiaries who prefer less crowded places or being in close contact with specialists/service providers would refer to private centres which are usually smaller specialized clinics or centres. In Iran, there are two public organizations for vulnerable groups. Depending on the needs of the clients, these services can be in the form of cash or subsidies.

They serve as a complementary support system for vulnerable and low-income people. The most famous public organization, which is open to all old and disabled citizens, is called BEHZISTI. They provide a wide range of services to different vulnerable groups such as drug addicts, single mothers, children in labour, Unaccompanied minors, mentally and physically disabled persons, persons of high age and so on. Some services are socio-psychological sessions, consultation services, warm houses and dormitories, mental and physical rehabilitation services, treatment of addiction and more. […]

Access to public services is equal for all citizens but, as mentioned, there are additional supports for vulnerable groups who are covered by the communities/organizations. There are some centres providing services for people in need under the supervision of BEHZISTI organization. Such services for vulnerable persons are free. For more info about BEHZISTI please refer to: https: //www.behzisti.ir/ […]

Behzisti Organization

Affiliated to the Ministry of Cooperatives, Labor, and Social Welfare, Behzisti orga- nization is one of the most important specialized organization which provides wide range of services to vulnerable groups including psychological services such as telephone, in-person and virtual counselling, anxiety screening for 5 to 6-year-old children, pre-marriage training, family-life training, life-skills training, psychological interventions in crises and natural disasters, etc. Following, you may find further details on the main services of Behzisti Organization:

Social Emergency (123)

By dialing 123, people can contact experts to express their problems and receive specialized services. The experts include social workers and trained psychologists who provide specialized services to the target groups (people who are at risk or socially injured) 24 hours a day and, if necessary, refer them to intervention centers for social, psychological, and legal interventions. Eligible people to receive these services are: Divorced couples and people who have serious family conflicts, women and girls who are at risk of social harm or are already harmed socially, people who intend to commit suicide or have attempted suicide, street and working children, abused spouses and children, people who are suffering from sexual identity disorders, runaway girls and boys, other people of all ages who are in critical situations.

Counselling

Behzisti provides counselling services through telephone to the public. Telephone counselling aims to address people’s immediate psychological needs and improve their mental health. The counsellor helps callers to identify their needs and find solutions to their problems and enhance their abilities to make decisions. In all provinces, the governmental landline, 1480, answers the problems of callers in the fields of premarriage, family, children and adolescents, education, employment, etc., from 8 am to 6 pm. The counselling is free of charge, and the caller should only pay a small amount for call charges.

Non-governmental counselling centers are also providing telephone counselling services (10-digit numbers) in 8 provinces. Respective telephone numbers can be found at: http://moshaver. behzisti.ir/page.aspx?id=1480

Contact details of in-person counselling centers can be also found at: http://moshaver.behzisti.ir/ngo.aspx“ (ZIRF, Juli 2022, S. 8-9)

Das Borgen-Projekt ist eine Interessengruppe mit Sitz in den USA, die es sich zum Ziel gesetzt hat, die politische Aufmerksamkeit auf die globale Armut zu lenken.

·      Borgen Project (The): The State of Mental Health in Iran, 24. März 2021
https://borgenproject.org/mental-health-in-iran/

„Mental health issues are prevalent in Iran. About one-fifth of people have a mental illness or substance disorder, amounting to nearly 10% of the total disease burden. Over 60% of Iranians do not receive any treatment, and only 15-25% get proper treatment. Many do not seek treatment, and resources are currently limited to treating disorders for those who do.

While 64% of the population reside in urban areas, mental health is nearly identically prevalent in rural areas. Iran aims to aid urban and rural areas accordingly. The Iranian health care initiative intends to soften the gap between urban-rural access to healthcare. Part of the initiative is lessening the disparity of primary health care between urban and rural areas. The gap has decreased significantly, and Iran has begun integrating mental health treatment into its primary care system.

Therefore, rural areas are obtaining near-equal access to mental health treatment as urban areas. However, only 3% of Iran’s healthcare spending goes toward mental health, which complicates its success in treating mental health. Iran has a robust healthcare system, allocating more money toward mental health should down-trend its number of mental health cases. […]

Aforementioned, Iran integrated mental health treatment into its primary care system in 1989, improving access to treatment. As the country increases its healthcare expenditure, mental healthcare funding would increase within Iran’s primary care system. With the steps occurring to reduce the percentage of people needing mental health treatment, resources such as having enough facilities, hospital beds and doctors to treat people are the next step for Iran.“ (The Borgen Project, 24. März 2021)

Vandad Sharifi ist Wissenschaftler an der Abteilung für Psychiatrie im Roozbeh-Krankenhaus der Medizinischen Universität Teheran.

·      Sharifi, Vandad et al.: Specialized Outpatient Services: Community Mental Health Centers (CMHCs), In: Iran J Psychiatry; 16:1, Jänner 2021, S. 87-93
https://pmc.ncbi.nlm.nih.gov/articles/PMC8140302/pdf/IJPS-16-87.pdf

„According to the Iranian Mental Health Survey (IranMHS) in 2011, almost 1 in 4 individuals are affected with psychiatric disorders. It is also reported that these illnesses are the leading cause of disability among 10-40 year-olds in Iran. Despite available effective treatments, there is a huge treatment gap, where about two-thirds of patients do not receive adequate treatments. […]

Over the past 40 years, an evolution was occurring in Iran’s mental health care to move from the traditional hospital-based to community-based and primary mental health care. Integration of mental health care into the primary care was one of them. In Iran, the National Mental Health Program, launched in 1988, was based on the integration of mental health into primary health services. It achieved great accomplishments in rural areas, but it was not efficient enough in cities, especially in big metropolitan areas, mainly due to the lack of coordination between basic and specialized strong private sectors as well as poor monitoring. In the late 2015, the concept of establishment of community mental health centers (CMHCs) was raised. The main objective of the CMHCs was to deliver comprehensive mental care, including treatment and rehabilitation of individuals with mental disorders, in a specified catchment area without relying on psychiatric hospitals. Accessibility, comprehensiveness, multidisciplinary care, continuity of care, effective link between different levels of care, and a focus on prevention are the advantages of the CMHCs. […]

In Iran, due to the weakness of mental health integration into primary care in cities, rapid urbanization, and incoordination between mental health professionals and services, CMHCs were proposed in 2004 in the Department for Mental Health and Substance Abuse Treatment at the Ministry of Health and Medical Education. The services of the Iranian model of CMHCs were designed and developed in 2007-2009, and in 2010, the first CMHC was established in the district 16 of Tehran. In the subsequent years, several other centers were established in Tehran, Zanjan, Tabriz, Kerman, Sanandaj, and several other cities. These CMHCs worked with private sector general practitioners (GPs) using a collaborative care approach to enhance detection and treatment of mental disorders in primary care. In addition, aftercare services were provided for patients with severe mental disorders in primary care that included home care and telephone follow-ups. Several studies have shown the effectiveness of these services in care delivery and patient satisfaction and improvement of general practitioners' performance in these centers. In 2015, the Ministry of Health and Medical Education incorporated the service model of CMHCs as the specialized outpatient services' model into the Seraj program, which is a comprehensive mental and social health services for Iranian communities. For the purpose of such incorporation into Seraj, services of the existing CMHCs were expanded to include rehabilitation services for severe mental disorders (see below).

The Seraj program

The Seraj program provides 3 packages of services for defined catchment areas: (a) basic mental health services in primary health centers, (b) specialized services through community mental health centers (CMHCs) supported by psychiatric wards of general hospitals (for psychiatric hospitalizations), and (c) a community action package. This program is designed and implemented to create a national model for provision of prevention, treatment, and rehabilitation services and social support for mental health of Iranian population. The aim of the program is to promote the quality of patient's life by improving service utilization and mental health services (including early illness detection, proper treatment, and rehabilitation) along with enhanced social support. As described elsewhere, the Seraj program has been set up in 3 cities (Oskoo, Bardsir and Quchan) as a pilot program. Because of its success, the program was expanded to include 8 cities.“ (Sharifi et al., Jänner 2021, S. 88)

„Service model of CMHCs were incorporated into the Seraj program in 2015. The specialized outpatient services of the existing CMHCs were expended as mentioned below.

The CMHC Services in the Seraj Program

The CMHCs in the Seraj program provide mental health care to 2 groups of patients in a defined catchment area:

1) Patients affected with common mental disorders (including depressive and anxiety disorders).

2) Patients with severe mental disorders (including schizophrenia, schizoaffective, and bipolar disorders). The services include collaborative care for the former, and aftercare and day rehabilitation for the latter.

All these services are evidence-based and their effectiveness and applicability have already been documented in the past studies in Iran. These services are provided to improve patients' health, quality of life, and satisfaction with care. Below, each service component of the CMHCs is described in detail.

Day Rehabilitation

Day rehabilitation services are used to provide care to patients with severe mental disorders by multidisciplinary teams. Psychiatrists and other mental health professionals visit all patients and tailor services to individual needs of patients during a specified period of time. The objectives of day rehabilitation are:

1)Improve patients' function and quality of life,

2)Prevent disability and deterioration,

3)Increase patients and families' knowledge and skills about severe mental illnesses, their treatments, and coping with the illness,

4)Prevent relapse and readmission and shorten the duration of rehospitalization.

Every rehabilitation session lasts about 60 to 90 minutes. Every patient receives at least 2 sessions a day and at least 3 days a week. Day rehabilitation clients routinely come to the center in the morning and leave in the afternoon. The specific rehabilitation services are listed in Table 1.

Aftercare

Aftercare includes telephone follow-ups and home visits along with patient and family psychoeducation for patients affected with severe mental illnesses. Each patient will receive either home visits or telephone follow-ups, depending on his/her needs. Those with high rehospitalization rate and/or poor compliance with treatments are offered with home visits, and others will receive telephone follow-ups.

Home Visits

In home visits, multidisciplinary teams are responsible for patient care after discharge from hospitals. Each team includes a psychiatrist, a general practitioner, and a psychiatric case manager who is either a psychiatric nurse, a clinical psychologist, or social worker. The teams deliver treatment and care to patients in their home. The case manager is responsible for coordination with other services, such as psychiatric wards/hospitals and other social services to facilitate utilization of services. The objectives of home visits are to prevent relapse, readmission, and shorten the duration of rehospitalization, enhance treatment adherence,to increase patient and family satisfaction, and to improve patients' function and quality of life. The first home visit takes place within 2 weeks after discharge; then, patients are visited at least once a month. Unstable patients or patients in crisis are visited in shorter time intervals or through emergency visits. Specific home visits services are listed in Table 1.

Telephone Follow-ups

A case manager of the aftercare team (usually a psychiatric nurse or a social worker) collaborates with hospitals to assess and enroll patients with severe mental disorders immediately following discharge. After discharge from the hospital, case managers make telephone calls to patients to increase adherence to outpatient visits and treatments. They remind patients and their families about the appointments and educate them to increase patients’ treatment compliance. The objectives of telephone follow-ups are:

1)To enhance outpatient attendance and medication adherence,

2)Enhance patients' knowledge and attitude about mental illness,

3)To reduce relapses and readmissions and shorten the duration of rehospitalizations.

Case managers make calls a day before the appointments as reminders and then one day after the appointment to inquire about patients’ adherence to appointments and to coordinate the next appointment. Eligible patients for home visit services will be excluded from the telephone follow-up services. Specific telephone follow-up services are shown in Table 1. […]

As presented in Table 2, in the first 4 years since the launching of the Seraj program (2016-2020) in 2 pilot areas, including Oskoo and Bardisr, more than 6200 patients received care at the CMHCs. As can be seen a sizeable number of these patients were those with severe mental disorders and the rest were patients with common mental disorders who were referred from the primary care physicians (V. Asl-Rahimi, A. Bahram-Nejad, personal communication). Since the care was mostly focused in urban areas and referrals from rural health centers were negligent, the proportion of patients to the urban population are reported as well .“ (Sharifi et al., Jänner 2021, S. 89-90)

Informationen zur Entwicklung der Bestimmungen betreffend psychische Gesundheit im Iran im 20. Jahrhundert finden sich in folgendem Artikel von Hashem Rastegar, der Wissenschaftler im Fachbereich Gesundheitspolitik und -management an der Fakultät für Management und Medizinische Informatik der Medizinischen Universität in Täbris im Iran ist, und anderen Autor·innen:

·      Rastegar, Hashem et al.: The dynamics of mental health policy in Iran over the last century, In: BMC Psychology (2025) 13:51, 2025
https://link.springer.com/c26/05/2026ontent/pdf/10.1186/s40359-025-02384-x.pdf