Reform of Mental Health Services in Moldova a project mandated by the Swiss Agency for Development and Cooperation Victoria Condrat Local Project Manager Trimbos Moldova, Private Institution

 Title: Reform of Mental Health Services in Moldova  Duration Phase 1:  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 2

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

8 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 options Community 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

Target beneficiaries: Mental health service users in Moldova NIVEL Institute Netherlands Romanian League for Mental Health Romania 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 10

Capacity building Study 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 views on Trimbos articles COMMUNICATION & ANTI-STIGMA

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