Integrating ontology and knowledge graphs for intelligent assessment and feedback in E-learning systems.

Mental disorders, accounting for 13% of the global disease burden and 32.2% of Disability-Adjusted Life Years (DALYs), represent a major challenge to health systems worldwide []. This issue is more severe in the Eastern Mediterranean Region, where Iran is located. According to World Health Organization reports, over 20% of the population in this region faces mental health-related problems []. The Mental Health Atlas report also highlights significant gaps in mental health resources and services globally []. Iran’s National Health Survey indicated that approximately one-quarter of the population (23.6%) met the diagnostic criteria for at least one mental disorder over a 12-month period []. These disorders have been identified as the leading cause of disability among the 10–40 age group in Iran []. More than half of individuals with mental disorders lack access to necessary care and appropriate interventions, and over 30% of the household income of families with patients suffering from severe psychiatric disorders is spent on direct treatment costs []. To address mental health challenges, Iran has developed programs to integrate mental health services into the primary health care system. These programs include interventions such as screening and identification of disorders across different age groups, psychosocial empowerment, self-care during disasters and emergencies, community-based preventive programs, prevention of child and spousal abuse, prevention of addiction and substance use disorders, and suicide prevention []. However, significant challenges in implementing these programs underscore the critical need for systematic performance evaluation in this area. Achieving Universal Health Coverage (UHC), which is included in the United Nations Sustainable Development Goals (SDGs), requires strengthening Primary Health Care (PHC). However, a World Health Organization report indicated that at least half of the global population still lacks access to essential health services []. This underscores the necessity of strengthening primary care systems and developing effective performance evaluation methods by comparing outcomes with expected targets []. These efforts align with international mental health objectives, such as reducing the treatment gap (mhGAP) [] and improving access to essential mental health services []. This process not only assesses the efficiency and effectiveness of programs but also ensures public accountability and transparency [].