Tunisia Way

There is very good primary health care in the country. These facilities and staff are providing good general health care. There has been increased importance given to this sector of health care in the health planning during the past decade. Currently, no systematic effort to integrate mental health care with primary health care has been made. The only activities have been the preparation of a doctors’ manual, training for 60 health workers, 120 nurses and about 500 general physicians. There is no system of follow-up of the training and evaluation of the mental health care provided by the trained persons.

The school health programme in the country is very well developed, consisting of about 500 public health physicians and 700 nurses. This has could include mental health components. Currently, only one centre carries out mental health work.

Research

Currently, a general population epidemiological survey of depression and schizophrenia in the Ariana area is in progress. Similarly, other studies about the prevalence of mental illness in those housed in the homes of the elderly and divorce have been completed.

There are a number of current limitations. The most important ones are limited number of trained human resources and their unequal distribution, overuse of the tertiary level facilities and lack of secondary level care, lack of recording and reporting of data, no programme evaluation, lack of ongoing relationship with the primary health care level and lack of coordination.