Widespread collapse, glimpses of revival: a scoping review of mental health policy and service development in Central Asia

Akmal Alikhan Aliev, Tessa Roberts, Shakhnoza Magzumova, Liliia Panteleeva, Saida Yeshimbetova, Dzmitry Krupchanka, Norman Sartorius, Graham Thornicroft, Petr Winkler*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

13 Citations (Scopus)


Purpose: We aimed to map evidence on the development of mental health care in Central Asia after 1991. Method: We conducted a scoping review complemented by an expert review. We searched five databases for peer-reviewed journal articles and conducted grey literature searching. The reference lists of included articles were screened for additional relevant publications. Results: We included 53 articles (Kazakhstan: 13, Kyrgyzstan: 14, Tajikistan: 10, Uzbekistan: 9, Turkmenistan: 2, Multinational: 5). Only 9 were published in internationally recognised journals. In the 1990’s mental health services collapsed following a sharp decline in funding, and historically popular folk services re-emerged as an alternative. Currently, modernised mental health policies exist but remain largely unimplemented due to lack of investment and low prioritisation by governments. Psychiatric treatment is still concentrated in hospitals, and community-based and psycho-social services are almost entirely unavailable. Stigma is reportedly high throughout the region, psychiatric myths are widespread, and societal awareness of human rights is low. With the exception of Kyrgyzstan, user involvement is virtually absent. After many years of stagnation, however, political interest in mental health is beginning to show, along with some promising service developments. Conclusions: There is a substantial knowledge gap in the region. Informed decision-making and collaboration with stakeholders is necessary to facilitate future reform implementation.

Original languageEnglish
Pages (from-to)1329-1340
Number of pages12
JournalSocial Psychiatry and Psychiatric Epidemiology
Issue number8
Publication statusPublished - Aug 2021


  • Central Asia
  • Deinstitutionalization
  • Mental health


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