A comparative study of patient satisfaction with mental health services in Armenia and Moldova

Abstract

Introduction: Mental health is as important as physical health to the overall well-being of individuals, societies, and countries. It is accountable for 12% of the global burden of disease, whereas health budgets of the majority of the countries allocate less than 1% of their financial resources to mental health care. Morbidity rates for psychiatric diseases in the Republic of Armenia have increased from 228 per 100,000 general population in 2006 to 244 in 2009. The prevalence of mental and behavior disorders among the population of the Republic of Moldova grew from 2,599 per 100,000 people in 2006 to 2,649 in 2009. This qualitative research study examines and compares patient satisfaction with mental health care services in Armenia and Moldova. Methods: An exploratory qualitative study on patient satisfaction with mental health care services was conducted in Yerevan and Chisinau. The study collected data via mainly in-depth interviews. The study population included caregivers of 18 to 65 years old mentally ill patients. A semi-structured in-depth interview guide was developed in English, and translated into Armenian and Romanian. A trained interviewer conducted 21 in-depth interviews and one focus group discussion in Armenia; the student investigator conducted 24 in-depth interviews in Moldova. Detailed notes were taken during the interviews and later transcribed in English. The transcripts were coded by words, phrases and ideas, and analyzed by hand. Results and discussion: Four domains expressing the main concerns that the participants had, that influenced their patients‟/caregivers‟ satisfaction and revealing information that would be more helpful to improve the quality of care in mental health were: financial access, commodities in hospital, medical staff qualifications and attitudes, and overall satisfaction of patients and relatives. Part of the similarities between Armenia and Moldova was the fact that participants and patients were overall satisfied with the services, despite the shortage of drugs at times, additional expenses it caused and uncomfortable conditions within the hospitals. Main findings include rating professionals as highly qualified, even though informal payments were still present. Recommendations: Based on the results of the study the following recommendations were made: I. Conduct regular patient satisfaction assessments in the mental health care sector II. Use patient satisfaction assessments to inform mental health care policy and legislation development III. Use the assessments of patient and caregiver satisfaction with mental health care as part of the overall evaluation of the sector to improve and maintain service quality IV. Train mental health care providers on basic human rights/patient-provider communication V. Control/improve the basic conditions for patients at the mental health care hospitals/dispensaries, including food, bedding, and recreation time VI. Increase patients‟/caregivers‟ awareness of their rights and standards of care VII. Ensure social protection mechanisms for people with mental health disorders.