Reform of Mental Health Services in Moldovaa project mandated by the Swiss Agency for Development and Cooperation

Victoria CondratLocal Project Manager

Trimbos Moldova, Private Institution

Title: Reform of Mental Health Services in Moldova

Duration Phase 1: 2014-2018

Consortium leader: Trimbos Institute (Netherlands Institute for Mental Health and Addiction), Netherlands

Consortium partners: Netherlands Institute for Health Services Research (NIVEL), Romanian League for Mental Health, Luzerne Psychiatrie (Switzerland)

Beneficiary country: Moldova

Project Implementation Unit: Private Institute “TRIMBOS MOLDOVA”

Project overview

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Improvement of wellbeing of mental health service

users through access to effective mental health services

at the community level, closer to their homes

Overall envisaged impact of the project

Men and women with mental health problems in 4 districts have equitable access to functional and sustainable community-based services (primary care, community based care, acute inpatient mental health services in district hospitals) according to their needs

Outcome 1. Access to services

Decision- and policy-makers in relevant sectors at national level and local stakeholders (local authorities, managers of institutions) in 4 project-districts, in close cooperation, implement integrated care for people with mental health problems and the new model of care in the community.

Outcome 2. Intersectorial cooperation

Outcome 3. Advocacy and awareness raising Policy- and decision-makers at national level and relevant stakeholders at local level in 4 project-districts (local authorities, managers and

professionals, as well as community members) are supportive of CBMHS and create an enabling environment for people with mental health problems and their caregivers, in order to exercise their rights.

Outcome 3. Advocacy and awareness raising

Mental health legislation and regulatory framework revised to enable services to function and mandate access to community-

based mental health care

Financial mechanisms are revised to ensure sustainable

functioning of the community-care model of mental health

services

Clinical guidelines for key conditions: depression, anxiety, schizophrenia, bipolar disorder,

alcohol addiction, autism, dementia

Curricula for medical (doctors and nurses) and non-medical

professionals (clinical psychologists and social workers)

revised and/or developed

Improved capacity and competences (training) of health professionals to

provide evidence-based mental health care in 4 project districts, and

nationwide

Functional community-based mental health services in 4 districts linking

primary (family practices), secondary (community mental health centres and (regional general hospitals) and tertiary

care (psychiatric hospitals)

Quality management system for mental health services developed and

tested in 4 project districts

Equitable access to functional and sustainable community-based services according to needs

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Intersectoral partnerships and resource pooling

Decision- and policy-makers in relevant sectors at national & local level in 4 project-districts work together to implement integrated community-based

care

Mechanisms for intersectoral cooperation for community-based mental health services

developed and implemented in the 4 districts

Professionals in 4 districts in the health and social sector have developed capacity to work

together as a joint multidisciplinary team providing services related to mental health

care

Enabling people with mental health problems and their caregivers

Relevant stakeholders are informed & enabled to play a facilitative role in implementing the new

model of care

Communication strategy and action plan on reducing stigmatization and discrimination

developed

Tools developed for providing service users and their care-givers with information about rights,

care standards and treatment optionsCommunity awareness and acceptance increased

Policy/decision-makers & key stakeholders at national & local level in 4 project-districts create an enabling environment for

people with mental health problems and their caregivers

10Target beneficiaries: Mental health service users in Moldova

NIVEL InstituteNetherlands

Romanian League for Mental HealthRomania

TRIMBOS INSTITUTE(consortium leader)

Luzerne Psychiatrie (Outpatient Services) Switzerland

SDC Moldova (Country Office)

Ministry of Health of the Republic of Moldova

Responsible for implementation of the National Mental Health Action Plan

INTERNATIONAL CONSORTIUM

Project Implementation Unit:

Private Institute Trimbos Moldova (non-profit

organisation) set up by Trimbos Netherlands

(Chisinau, Moldova)

Collaboration with local key stakeholders

Health Insurance Company

Ministry of Labour, Social Protection and Family

Mental health professionals

Primary care professionals

Universities and continuous education institutions (curricula)

+ Consultants (clinical experts, lead professors,

train-the-trainers)

Swiss Agency for Development and Cooperation (SDC)

(Switzerland’s international cooperation agency within the Federal Department of Foreign Affairs)

Memorandum of Understanding

+ GGZ Noord-Holland-Noord &

FIT Academy

Local authorities in 4 project districts

Capacity buildingStudy visit to the Netherlands: Moldovan decision-makers, with follow-up visit in November 2014

Training of Trainers in Moldova & Netherlands – 18 professionals (psychiatrists, psychologists, social assistants, nurses) are being trained to further increase capacities in Moldovan professionals (June-July 2015).

Organization of 5 local trainings for community-based mental health professionals (February, April and May 2015) and study visit to Netherlands (March 2015)

Legislation, policy and clinical guideline development

Working on analyzis and evaluation of existing MDA mental health legislation, norms and responsibilities

Synthesis of international evidence base for the multidisciplinary guidelines on depression and schizophrenia (March 2015)

Workshop with key stakeholders on adapting the evidence base for depression and schizophrenia to the Moldovan context (April 2015)

Work on development of clinical guidelines for depression & schizophrenia

Community Mental Health Centres (CMHCs) in 4 districts

Soroca, Orhei and Cimișlia: community centers have been renovated & furnished, the teams are starting their activity

Cahul: initial stage of development; the team is trained

• 2 extended TV appearances• 24 articles published in all major printed and online media in Moldova• 60 000+ views on Trimbos articles

COMMUNICATION & ANTI-STIGMA

THANK YOU!