title: Service Users and Providers Expectations of Mental Health Care in Iran: A Qualitative Study.
abstract: BACKGROUND
  Mental disorders are known to be an important cause of disabilities worldwide. Despite their importance, about two thirds of mentally ill people do not seek treatment, probably because of the mental health system's inability to decrease the negative side effects of the interaction with the mental health services. The World Health Organization has suggested the concept of responsiveness as a way to better understand the active interaction between the health system and the population. This study aimed to explore the expectations of mental health service users and providers.
  
  
  METHODS
  Six focus group discussions were carried in Tehran, the capital of Iran. In total, seventy-four participants comprising twenty-one health providers and fifty-three users of mental health system were interviewed. Interviews were analyzed through content analysis. The coding was synchronized between the researchers through two discussion sessions to ensure the credibility of the findings. The results were then discussed with two senior researchers to strengthen plausibility.
  
  
  RESULTS
  Five common domains among all groups were identified: accessibility, quality of interpersonal relationships, adequate infrastructure, participation in decisions, and continuity of care. The importance of cultural appropriateness of care was only raised by service users as an expectation of an ideal mental health service.
  
  
  CONCLUSIONS
  Both users and providers identified the most relevant expectations from the mental health care system in Iran. More flexible community mental health services which are responsive to users' experiences may contribute to improving the process of care for mental health patients.
authors.affiliation: 1. Social Determinants of Health Research Centre, University of Social Welfare and Rehabilitation Sciences , Tehran, Iran ; 2. Dept. of Public Health and Clinical Medicine, Umeå International School of Public Health, Umeå University , Umea, Sweden.
authors.forename: Ameneh
authors.initials: A
authors.lastname: Setareh Forouzan
authors.affiliation: 3. Dept. of Social Work, Umea University , Umea, Sweden.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Ghazinour
authors.affiliation: 1. Social Determinants of Health Research Centre, University of Social Welfare and Rehabilitation Sciences , Tehran, Iran.
authors.forename: Masoumeh
authors.initials: M
authors.lastname: Dejman
authors.affiliation: 4. Dept. of Social Welfare Management, University of Social Welfare and Rehabilitation Sciences , Tehran, Iran.
authors.forename: Hassan
authors.initials: H
authors.lastname: Rafeiey
authors.affiliation: 1. Social Determinants of Health Research Centre, University of Social Welfare and Rehabilitation Sciences , Tehran, Iran.
authors.forename: Monir
authors.initials: M
authors.lastname: Baradaran Eftekhari
authors.affiliation: 2. Dept. of Public Health and Clinical Medicine, Umeå International School of Public Health, Umeå University , Umea, Sweden.
authors.forename: Miguel
authors.initials: M
authors.lastname: San Sebastian
keywords: Iran; Mental health; Responsiveness