Barriers to mental health screening in Iran’s primary healthcare system and its implications for service improvement

Introduction Mental disorders impose an increasing burden on healthcare systems, particularly in low- and middle-income countries (LMICs). Although Iran integrated mental health services into primary healthcare in the 1980s, screening implementation remains challenging. This study aimed to identify barriers to mental health screening in PHC centres in the western districts of Tehran Province and to derive evidence-informed implications for improving service delivery.Methods A qualitative study using thematic analysis was conducted among twelve healthcare providers from comprehensive health centres in Shahriar County, selected via purposive sampling. Data were analysed inductively using Braun and Clarke’s framework.Results The study identified three key themes: (1) organisational and managerial challenges, such as centre overcrowding, multitasking demands on healthcare providers, and staff job-related issues; (2) technical and infrastructural barriers, including platform and software problems and a lack of private space; and (3) socio-cultural challenges, encompassing cultural differences, distrust, and difficulties in identifying vulnerable populations.Conclusion Mental health screening in Iran’s PHC faces major organisational, technical, and socio-cultural challenges. Improving effectiveness requires more staff, better tools and infrastructure, culturally sensitive strategies, and support for vulnerable groups. Further research should incorporate additional stakeholders’ perspectives and examine strategies for strengthening screening and follow-up services.