A window of opportunity for the transformation of national mental health policy in Turkey following two major earthquakes.
Striking at the nation's highly populated industrial heartlands, two massive earthquakes in 1999 killed over 25,000 people in Turkey. The economic cost and the humanitarian magnitude of the disaster were unprecedented in the country's history. The crisis also underscored a major flaw in the organization of mental health services in the provinces that were left out of the 1961 reforms that aimed to make basic health services available nationwide. In describing the chronology of the earthquakes and the ensuing national and international response, this article explains how the public and governmental experience of the earthquakes has created a window of opportunity, and perhaps the political will, for significant reform. There is an urgent need to integrate mental health and general health services, and to strengthen mental health services in the country's 81 disparate provinces. As Turkey continues her rapid transformation in terms of greater urbanization, higher levels of public education, and economic and constitutional reforms associated with its projected entry into the European Union, there have also been growing demands for better, and more equitably distributed, health care. A legacy of the earthquakes is that they exposed the need for Turkey to create a coherent, clearly articulated national mental health policy.
Munir
Kerim
K
Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
Ergene
Tuncay
T
Tunaligil
Verda
V
Erol
Nese
N
D000293:Adolescent; D000328:Adult; D002423:Cause of Death; D002648:Child; D003156:Community Mental Health Services / Q000458:organization & administration / Q000592:standards / Q000600:supply & distribution; D004189:Disaster Planning / Q000458:organization & administration; D004190:Disasters / Q000706:statistics & numerical data*; D018166:Health Care Reform; D006291:Health Policy; D006301:Health Services Needs and Demand; D006302:Health Services Research; D019456:Health Transition; D006801:Humans; D008605:Mental Health Services / Q000458:organization & administration* / Q000592:standards / Q000600:supply & distribution; D009313:National Health Programs / Q000191:economics / Q000458:organization & administration* / Q000592:standards; D011050:Policy Making; D011787:Quality of Health Care / Q000592:standards; D012574:Schools / Q000458:organization & administration / Q000600:supply & distribution; D014421:Turkey; D014480:United Nations / Q000458:organization & administration