Mental Health and Mental Health Care in Iran: Addressing Social Inequalities

Background/Objectives: Iran carries a significant burden of mental health disorders. This study aimed to describe the status of mental health and mental health care in Iran between 2012 and 2023, addressing inequalities and mapping existing challenges in the mental health care system. Methods: A systematic literature review was conducted. Databases including Medline, CINAHL, APA PsycINFO, Scopus, Web of Science, and the Cochrane Library, as well as local databases such as SID, Magiran, and Noormags, were searched to identify studies related to mental health care in Iran. A total of 59 studies met the inclusion criteria. An inductive approach and thematic analysis were used to synthesize themes from the data. Results: Lower socioeconomic status (SES) was associated with higher rates of mental disorders due to poverty-related stressors and limited access to quality care. Gender disparities revealed that women are more vulnerable to mental health problems, exacerbated by perceived gender inequality. Ethnic minorities and undocumented migrant populations faced inadequate healthcare services, resulting in poorer mental health outcomes. Children and older adults also experienced mental health challenges influenced by sociodemographic factors. The main challenge for mental health care is establishing mechanisms to ensure more equitable access for all citizens. Additional challenges include limited awareness among policymakers, insufficient budget allocation, weak prevention programs, and poor intra- and inter-sectoral coordination and collaboration. A shortage of mental health care providers, as well as deficiencies in structure, system processes, and resources, further hinder progress. Conclusions: Socioeconomic factors exacerbate the challenges of Iran's under-resourced mental health system. To address these issues, equity considerations must be integrated into mental health policies. Key interventions include the routine monitoring of mental health indicators, expanding insurance coverage for mental health services, and establishing dedicated services for children.