Resolution
VI Barents conference in psychiatry
“Integration of Psychiatric Care in the Primary Healthcare System”
October 6-7, 2015
Venue: Arkhangelsk, Russia
The conference was attended by over 250 experts from the areas of the
Barents Euro-Arctic region of Russia (the Arkhangelsk Oblast, the Murmansk
Oblast, the Komi Republic, the Republic of Karelia, the Nenets Autonomous
Area), Norway, as well as guests from Khabarovsk, Yekaterinburg and leading
experts from Moscow and St. Petersburg.
The conference comprised two plenary and 5 parallel sessions at which 40
lectures were given. The lectures focused issues of integration of psychiatric
and somatic health-care, identification of mental health problems in primary
care, suicide prevention and drug addiction, and improvement of GPs’
competence in psychiatry.
It was emphasized that the long term Norwegian-Russian cooperation on
psychiatric health-care development in Arkhangelsk Oblast (since 2003) has had
a significant contribution to the integration of psychiatric care into primary
health care. One important inspiration has been the model of collaboration
between specialists at a district psychiatric center (Fauske CMHC – Nordland
psychiatric hospital) and the GP’s in its catchment area. Teaching practices for
Russian GPs and specialists have been arranged and the establishment of an
appropriate consultation model adapted to Russian conditions has been an ongoing
process. GPs from Arkhangelsk region have got training in diagnostics and a
structured interview for identification of mental disorders in primary care
(SPIFA) has been introduced into their practice. Seminars on psychotherapeutic
approaches with an emphasize on cognitive and behavioral techniques, has been
arranged as well. Joint seminars for public healthcare (PHC) professionals and
psychiatrists have been
held as well as multiprofessional team
training. Additional modules on psychiatry are included in post-graduate
education given by the Department of Family Medicine, Northern State Medical
University.
A new system of interaction between psychiatrists and GPs in delivery of
PHC has been under development in the region. In the territory of Primorsky
district “The Pomor Model” - a model of interaction between a specialized
psychiatric care and PHC service - has been implemented. This model is based
on the principle of multiprofessional teamwork and biopsychosocial approach in
the management and treatment of patients with mental health problems.
The suicidal rates in the Arkhangelsk region still remain high. In 2014 the
suicide rate was 29.8 per year per 100 thousand inhabitants, while the
nationwide rate was 19.5 and the global rate 14.5. This situation motivated
implementation of a Norwegian-Russian project aimed at suicide prevention in
the Arkhangelsk region (since 2009). As a result, more than 200 specialists from
various departments have been trained in suicide prevention.
In the northern territories of Russia there is a high rate of alcohol
psychoses and an increase of patients who use drugs, canabinoids in particular.
In order to solve this problem it’s important to use an interagency approach
involving cooperation of specialists from different institutions and departments.
In light of the foregoing, the conference participants agreed that
international cooperation gives an important contribution to the quality
improvement of psychiatric care and corresponds to the goals and objectives of
the modernization concept of psychiatric and narcological services in the
Arkhangelsk region.
During the discussions the conference participants came to the conclusion
that further improvement of mental health care requires the implementation of the
following activities:

strengthening preventive work in psychiatric care,

improving access to psychiatric care for the population through the
interaction of professionals from primary health care and specialized medical
care,

to continue education of GPs in psychiatry and narcology,

improvement of communication between experts,

practical implementation of a structured diagnostic interview for the
identification of mental health problems by GPs on a routine base,

dissemination of “The Pomor Model" of cooperation,

implementation of modern information and communication technologies
(ICT),

improvement of suicidological care, including care given to minors,

scientific evaluation of the effectiveness of implemented programs joint
professional efforts of psychiatrists, GPs, psychologists, experts in social work,
feldshers, nurses and others in the prevention, diagnosis, treatment and
rehabilitation of mental disorders.
The conference has the following recommendations for authority bodies and
stakeholders (in accordance with their role and responsibilities):
1. To include activities aiming at improving mental health care to the
population as well as the integration of mental health care into primary health
care into the regional target program on development of health are in the
Arkhangelsk region.
2. To take into account the results of the conference during the procedures on
preparation and review of agreements on international cooperation, in particular
between the Ministry of Health of the Arkhangelsk region and the regional
health administration of Helse Nord.
3. To promote the implementation of “The Pomor Model” in other districts of
the region.
4. To give priority to continuous improvement of GPs’ competence in
psychiatry.
5. To take benefit of the contribution of the Norwegian-Russian cooperation,
in particular the project "Improving mental health services in the Arkhangelsk
Region by integration of primary and specialized mental health services development of “The Pomor Model”, its implementation and evaluation" in the
improvement of mental health care in the Arkhangelsk region.
6. To suggest the creation of an interdisciplinary international network of
cooperation in the field of prevention of drug abuse in the territories of the
Barents Euro-Arctic Region.
7. To conduct conferences of the similar level on a regular basis.
8. To send the conference resolution to:
a. The Ministry of Health of the Russian Federation
b. The Ministry of Health of the Arkhangelsk region and other areas /
administrative territories of the Barents Region
c. Department of International Relations and State Protocol of the
Governor of the Arkhangelsk Oblast Administration and the Government
of Archangelsk Region
d. Northern State Medical University, to the Rector
e. Northern Norway Regional Health Authority, Helse Nord
f. University Hospital of North Norway, to the Director General and the
Head of mental health clinic
g. Nordland Hospital
h. University of Tromsø - The Arctic University of Norway, to the Dean
of the Faculty of Health Sciences and the Head of the Department of
Clinical Medicine
i. Barents Secretariat
j. Barents Health Program, the Ministry of Health of Norway.