Mental Health in B&H

Psychiatric services are no longer the only organizational structures that take care of people suffering from mental and behavioral disorders. Fundamental changes of the context of the provision of services in mental health involve limited use of psychiatric hospital beds, open networks of mental health centers (MHC), the development of other services in the community, a multidisciplinary approach and teamwork, as well as inter-sectoral cooperation.

The goal of these processes is to build effective, efficient, and quality services of mental health, which follow the needs of users and are available to as many people as possible, in the context of a compact and integrated system of service delivery. The system of providing services in the field of mental health must be based on evidence-based practice and must be effective and acceptable.

Services in the field of mental health in Bosnia and Herzegovina are provided through a network of 50 mental health centers (MHC) – 31 in the FB&H, 18 in RS, and one in Brčko District. Each mental health center in the FB&H have 10 psychiatric beds intended for acute hospitalization and can be found on the psychiatric wards of general hospitals in the regions to which they belong. Services in the field of mental health in the secondary and tertiary levels are provided in university hospitals in Sarajevo, Tuzla and Mostar, and psychiatric wards in general hospitals in other major towns in the FB&H. In RS, health services on secondary and tertiary levels are provided in two university hospitals: Psychiatric Clinic in the Banja Luka Clinical Center, Psychiatric Clinic in Sokolac (contains forensic psychiatry), the Institute for treatment, rehabilitation and social protection of chronically mental ill patients Jakeš, and four psychiatric departments of general hospitals in Prijedor, Gradiška, Doboj, and Trebinje.

The goal of these processes is to build effective, efficient, and quality services of mental health, which follow the needs of users and are available to as many people as possible, in the context of a compact and integrated system of service delivery. The system of providing services in the field of mental health must be based on evidence-based practice and must be effective and acceptable.

Within the system of providing mental health services in the B&H community, three safe houses and two cooperatives were opened. Several associations for user services were also formed. In the past year, social welfare centers in local communities have begun to open up day care centers for people with mental health problems and day care centers for the elderly. This enhances the service system and mental health services.

One or more multidisciplinary teams are operating in mental health centers, depending on the size of the area they cover, the associated population, and available human resources. The teams are consisted of neuro-psychiatrists/psychiatrists, psychologists, social workers, medical technicians, special education teachers, speech therapists, and occupational therapists.

In most places in B&H where centers function, positive developments were achieved in rehabilitation and treatment, reducing the number of patients and length of hospital stay, the establishment of interdisciplinary collaboration within the healthcare system. This was achieved with both general/family healthcare teams and hospital services teams. A local level cross-sectoral cooperation with social welfare centers, schools, community groups, local authorities, etc. was also established.