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Bosnia and Herzegovina (BH) is located on the western part of the Balkan Peninsula. It has an area of 51 210 km ² and a population of 3 972 000. According to the Dayton Agreement of November 1995, which ended the 1992-95 war, BH comprises two ‘entities’ - the Federation of Bosnia and Herzegovina (FBH) and the Republic of Srpska (RS) - and the District of Brcko. The administrative arrangements for the management and financing of mental health services reflect this. The FBH, with 2 325 018 residents, is a federation of 10 cantons, which have equal rights and responsibilities. The RS has 1 487 785 residents and, in contrast, a centralised administration. Brcko District has just under 80 000 residents.
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International Psychiatry Volume 6 Number 1 January 2009
International Psychiatry Volume 6 Number 1 January 2009
the conditions for involuntary placement and treatment do
not include a therapeutic purpose. The law does not provide
free legal representation for detained patients. The legal situ-
ation of people in social care homes remains largely unclear,
as they are de facto detained but without the requirement for
judicial reviews or other legal safeguards. A major concern
for non-governmental organisations is that the new law has
not been fully implemented.
Council of Europe (2004) Recommendation No. Rec(2004)10 of the
Committee of Ministers to member states concerning the protection
of the human rights and dignity of persons with mental disorder
and its explanatory memorandum. See
jsp?id=775685 (last accessed November 2008).
World Health Organization (2001) Atlas – Country Profiles on Mental
Health Resources 2001. WHO.
CouNtry Profile
The country profiles section of International Psychiatry aims to inform readers of mental health experiences and experiments from around
the world. We welcome potential contributions. Please email
The organisation of mental health services
in post-war Bosnia and Herzegovina
Osman Sinanovic,¹ Esmina Avdibegovic,² Mevludin Hasanovic,² Izet Pajevic,²
Alija Sutovic,² Slobodan Loga³ and Ismet Ceric³
¹Department of Neurology and 2Department of Psychiatry, University Clinical Centre Tuzla, Medical Faculty, University of Tuzla,
75000 Tuzla, Bosnia and Herzegovina; ³Department of Psychiatry, Clinical Hospital Centre Sarajevo, Medical Faculty, University of
Sarajevo, 71000 Sarajevo, Bosnia and Herzegovina
Bosnia and Herzegovina (BH) is located on the western
part of the Balkan Peninsula. It has an area of
51 210 km2 and a population of 3 972 000. According to
the Dayton Agreement of November 1995, which ended
the 1992–95 war, BH comprises two ‘entities’ – the Federa-
tion of Bosnia and Herzegovina (FBH) and the Republic of
Srpska (RS) – and the District of Brcko. The administra-
tive arrangements for the management and financing of
mental health services reflect this. The FBH, with 2 325 018
residents, is a federation of 10 cantons, which have equal
rights and responsibilities. The RS has 1 487 785 residents
and, in contrast, a centralised administra tion. Brcko District
has just under 80 000 residents.
Mental health policy
and legislation
Healthcare systems in BH are regulated basically by the
entities’ different laws on healthcare and on health insur-
ance. Each entity and Brcko District is responsible for the
financing, management, organisation and provision of
healthcare. The health administration is centralised in RS,
through the Ministry of Health and Social Welfare, but in
FBH is decentralised – each of the 10 cantonal adminis-
trations has responsibility for healthcare through its own
ministries. The central Ministry of Health of the FBH, located
in Sarajevo, coordinates cantonal health administrations at
a federal level. The District of Brcko provides primary and
secondary care to its citizens. The mental health policies and
national programmes for mental health were created in 1999
and adopted in 2005. A law on the protection of persons
with mental disorders was adopted in 2001 and 2002 in FBH
(Official Gazette of BH, Nos 37/01 and 40/02), and in 2004
in RS (Official Gazette of RS, No. 46/04). These laws define
the rights of people and regulates the procedure for volun-
tary or involuntary admission to a psychiatric hospital.
Mental health service delivery
There are no private mental health institutions. Psychiatric
services are available for all citizens, paid from a special
national fund for healthcare, financed by mandatory health
insurance. The reform of mental health services began in
1995. The focus has been on care in the community, limiting
the use of psychiatric hospital beds, establishing a network of
community mental health centres (CMHCs), and develop ing
other services in the community, a multidisciplinary approach
and teamwork, as well as cooperation between sectors.
Each CMHC is responsible for general mental health in a
catchment area of 50 000–80 000 inhabitants; each has 10
psychiatric beds, intended for the acute admission of patients
(these beds are in fact on neuropsychiatric wards of regional
general hospitals). The CMHCs have many different functions,
including the promotion of mental health, early detection of
mental disorders, and the provision of multidisciplinary care
(Ceric et al, 2001).
Psychiatric services are provided throughout BH through
the network of 55 CMHCs and family medicine services at
primary care level. Secondary and tertiary mental health
services are provided in three psychiatric clinics, one depart-
ment of a university clinical centre, two general psychiatry
hospitals, two institutions for the treatment, rehabilitation
and social care of patients who are chronically mentally ill,
and neuropsychiatric wards in general hospitals in major
cities. In the reform of the mental health services, mentioned
above, new out-patient services were established, the existing
International Psychiatry Volume 6 Number 1 January 2009
International Psychiatry Volume 6 Number 1 January 2009 International Psychiatry Volume 6 Number 1 January 2009
primary care services were adapted to mental healthcare and,
in addition to the CMHCs, sheltered housing services for
patients with a chronic mental illness were established.
The reform of mental health services had a direct impact
on the development of users’ initiatives in BH: there are now
several user associations, which are provided with pro fessional
support and education from CMHCs and psychiatry clinics.
There are only two wards and two specialists for child
and adolescent psychiatry within the psychiatry clinics. There
are four institutions for the care of adults and children with
special needs and chronic mental disorders, mainly financed
from social welfare. Persons with drug addiction are treated
in a specialist institute and two other centres for addiction;
methadone is the predominant form of treatment.
There are no specific programmes for the mental
healthcare of minorities and the elderly in BH. There are
programmes for refugees and war victims of torture, through
a network of non-governmental organisations developed
during the war.
The provision of forensic psychiatry services is insuffi-
cient. Individuals with mental health problems who commit
criminal acts are treated in one forensic ward of a general
psychiatry department of a prison psychiatry hospital.
According to the Regional Office of the Mental Health
Project for South Eastern Europe (2004), in 2002 in FBH there
were 159 neuropsychiatrists, in RS 67 and in Brcko District 6.
The number of psychiatric beds in FBH was 632, in RS 640
and in Brcko District 30. These data differ from those in Table
1, from the World Health Organization (2005) and based on
data collected from 2001 to 2004.
Treatment of traumatised persons
At the beginning of the war (1992) knowledge about
the psycho logical consequences of war and therapeu-
tic approaches to post-traumatic stress disorder (PTSD) in
BH was rather poor. The therapeutic approach was based
on the experience of psychiatrists and their receptiveness
to the ideas suggested by the foreign literature and the
many foreign workers (Jensen & Ceric, 1994; Hasanovic
et al, 2006). At the end of the war, various psychosocial
programmes were organised by the government and inter-
national non- governmental organisations (de Jong & Stickers,
2003; Nelson, 2003). The psychosocial approach to trauma
aimed to reduce not only the risk of serious mental disorders
but also stigma, through mass education about the psycho-
logical consequences of trauma. Working with traumatised
people during the war, we perceived that religious people
coped more successfully with difficulties than those who
were not religious. In selected cases, spirituality and religion
are therefore used in the process of healing, and so they
found their place in educational programmes and psycho-
therapeutic treatment. In hospitals, adequate rooms for
the spiritual and religious needs of patients were allocated
(Pajevic et al, 2005).
Psychiatric training
There are five medical faculties, two in RS and three in FBH,
with different education programmes, all lasting 6 years. At
four medical faculties, the undergraduate courses include only
two semesters of psychiatry, while at one medical faculty the
undergraduate course has only a neuro psychiatry element.
Medical schools are associated with psychiatric clinics. After
graduation from the medical faculty and a 1-year internship,
specialisation in neuro psychiatry/psychiatry is available, author-
ised by the entity’s Ministry of Health.
Specialist training is different in the two entities. In FBH
there is specialisation in neuro psychiatry, which takes 4 years,
with 20 months of psychiatry, while in RS there is a pro-
gramme of education in psychiatry only, which also lasts 4
years. There is no unified national programme of psychiatric
education for residents.
Psychiatric sub-specialties and allied professions
The educational programme for the specialisation in neuro-
psychiatry/psychiatry does not include psychotherapy.
Residents from neuropsychiatry/psychiatry are familiar with
the theoretical basis of psychotherapy mainly from their
undergraduate education. There are no institutions for edu-
cation in psychotherapy in BH, and there is no regulation
of psychotherapy licences. Education in psychotherapy is
organised from psychiatry clinics and by psychologists’ asso-
ciations, in cooperation with psychotherapist educators from
other European countries.
The only recognised sub-specialisations are in social psy-
chiatry and alcoholism and drug addiction, each taking 1
year. There is undergraduate education in psychology, but no
specialisation in clinical psychology. Furthermore, there is no
specialist training for psychiatric nurses. Additional psychiatric
education for nurses is provided through special education
programmes organised at the psychiatric hospitals.
Main areas of research
Psychiatric research in BH is insufficiently developed. There
is no professional psychiatry journal, nor a particular insti-
tute for research in psychiatry. Existing research projects are
under taken at the psychiatric hospitals and medical facul-
ties. The main areas of research are currently related to the
psycho social consequences of war trauma. Lack of a uniform
Table 1 Numbers of psychiatric beds and staff
Federation of
Bosnia and
of Srpska
Total number of psychiatric beds
per 10 000 residents
3.6 3.93 3.5
in psychiatry hospitals 2.4 0.91
in general hospitals 1 0.68 3.5
in other institutions 0.2 2.33
Numbers of professionals per
100 000 residents
psychiatristsa 2.3 –
neuropsychiatristsa1.8 1.2 7.0
nurses in psychiatry 10 19.4 21.8
psychologists 0.5 0.86 1.8
social workers 0.03 0.66 1.8
a In Bosnia and Herzegovina until 1992 there was education in ‘neuro psychiatry’
only; during the war (1992–95), medical doctors from the Republic of Srpska
were trained in Belgrade (Serbia), where they could gain a qualification in
Source: World Health Organization (2005).
International Psychiatry Volume 6 Number 1 January 2009
International Psychiatry Volume 6 Number 1 January 2009
database and insufficient development of entity and cantonal
public health services represents big problem for research,
particularly epidemiological studies.
Ceric, I., Loga, S., Sinanovic, O., et al (2001) Reconstruction of mental
health services in Bosnia and Herzegovina. Medicinski Arhive, 55
(suppl. 1), 5–23.
de Jong, K. & Stickers, R. (2003) Early psychosocial interventions for
war-affected populations. In Early Interventions in Emergencies (eds R.
Orner & U. Schnyder), pp. 184–192. Oxford University Press.
Hasanovic, M., Sinanovic, O., Pajevic, I., et al (2006) Post-war mental health
promotion in Bosnia and Herezgovina. Psychiatria Danubina, 8, 74–78.
CouNtry Profile
Peru: mental health in a complex country
Marta B. Rondon
Assistant Professor, Department of Psychiatry and Mental Health, Universidad Peruana Cayetano Heredia and Attending Psychiatrist,
Hospital E Rebagliati, Essalud, Lima, Peru
Peru is a land of mixed cultures, multiple ethnic herit-
ages and severe economic inequities. Its history goes
back thousands of years, from accounts of the first inhab-
itants of the continent to the impressive Inca Empire, the
rich Viceroyalty of Peru and the modern republic, which
boasts one of the highest economic growth rates in South
America. Yet, in spite of such complex cultural develop-
ment, or perhaps because of it, 21st-century Peruvians
have substantial difficulties establishing a national identity
and recognising each other as members of the same com-
Persons with mental illness represent with poignant clarity
‘the other’ which we seem to have so much trouble accept-
ing as equals in terms of dignity and rights. When we look
at mental health in terms of legislation, services and human
rights, therefore, we are faced with exclusion and discrimina-
tion, unequal and inefficient use of resources, and lack of
public interest.
Mental health as a component
of public health
Peruvian psychiatrists have traditionally had a bio-psycho-
social approach to mental health and illness. Social psychiatry
studies, under the leadership of Rotondo and Mariategui in
the 1950s and early ’60s, were fundamental in the concep-
tualisation of mental health as a cultural construct (Perales,
1989). Another interesting development is that of psycho-
somatic medicine, under the leadership of Seguin, which
originated in the establishment of a psychiatric ward in a
general hospital, long before the Declaration of Caracas so
suggested, and which also is the precursor of the current
interest in women’s mental health and in the consequences
of violence in the country.
As far back as the 1960s, pioneers such as Baltazar
Caravedo and Javier Mariátegui saw mental illness as a major
obstacle to the development of the country, and they pointed
to the need to devote public effort and money to the promo-
tion of mental health and the prevention and treatment of
mental illness. Others have followed this path, especially after
the results of a large epidemiological study by the National
Institute of Mental Health were made public (Rondon, 2006).
Mental health and disorders
Anxiety, depression and schizophrenia are considered to be
the most relevant psychiatric disorders in Peru. The use of
alcohol, the prevalence of interpersonal violence and the high
tolerance of psychopathic attitudes have also been identified
as important (Instituto Especializado de Salud Mental, 2002).
Perhaps more striking than the prevalence of disorders is
the large number of people (14.5–41.0% of those surveyed),
mostly women, who report feelings of unhappiness, pre-
occupation and pessimism (Instituto Especializado de Salud
Mental, 2004).
Interpersonal violence, in all its modalities, plays a significant
role in the production of psychiatric morbidity. Gender-based
violence is widely tolerated, with roots in the complex culture
of the country (Rondon, 2003). According to a World Health
Organization multi-country study on violence against women,
adult women in the Andean region of Cusco are the most
physically abused females in the world, with those in Lima
faring just slightly better (García-Moreno et al, 2005).
In the 1980s, the country suffered much political violence,
largely targeted against the civilian population. This led even-
tually to the establishment of the Truth and Reconciliation
Commission at the turn of the century. It has recognised
that exposure to political violence during the internal armed
conflict in the 1980s has inflicted severe psychological
Jensen, B. S. & Ceric, I. (1994) Community-Oriented Mental Health Care
in Bosnia and Herzegovina: Strategy and Model Project. WHO Office
for Bosnia and Herzegovina.
Nelson, B. S. (2003) Post-war trauma and reconciliation in Bosnia and
Herzegovina: observations, experiences, and implications for marriage
and family therapy. American Journal of Family Therapy, 31, 305–316.
Pajevic, I., Sinanovic, O. & Hasanovic, M. (2005) Religiosity and mental
health. Psychiatria Danubina, 17, 84–89.
Regional Office of the Mental Health Project for South-Eastern Europe
(2004) Mental Health Policies and Legislation in South-Eastern Europe.
Available at (last
accessed November 2008).
World Health Organization (2005) Mental Health Atlas, Bosnia and Herze-
govina. Available at
MentalHealth/Files/BA_Mental_Health_Profile.pdf (last accessed November
... The majority of countries have issued mental health plans, indicating an intention to transition from institution-based service delivery to more community-based service delivery. Nevertheless, this review could only identify detailed information on reforms implemented in Bosnia and Herzegovina [27][28][29][30][31], Georgia [32], Lithuania [33] and Moldova [34]. In view of this, only broad themes on factors that facilitate and impede the implementation of community-based services could be derived. ...
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Background and objectives: Ukraine’s mental health system has been found to be inadequate and unresponsive to the needs of the population, in view of its emphasis on inpatient service delivery. This study sought to identify potential changes to the organization and financing of mental health services within the Ukrainian health system that would facilitate the delivery of mental health services in a community-based setting. Methodology: A systematic literature review was undertaken to identify organizational and financing features that have been successfully used to enable and incentivize the delivery of community-based mental health services in Central or Eastern European and/or former Soviet Union countries. Results: There was limited literature on the organizational and financing features that facilitate the delivery of community-based care. Key facilitators for transitioning from institution-based to community-based mental health service delivery include; a clear vision for community-based care, investment in the mental health system, and mechanisms that allow health funding to follow the patient through the health system. Conclusions: Ukraine should adopt strategic purchasing mechanisms to address inefficiency in the financing of its mental health system, and prioritize collaborative planning and delivery of mental health services. Ongoing reform of the Ukrainian health system provides momentum for instituting such changes.
... There are strong evidences about that provided from psychiatrists and psychologists in existing scienti ic and professional literature [1]. Events that are integral part of wars, natural catastrophes and similar situations brings to survivors plenty of pain and sufferings which overwhelmed their psychophysical capacities, so it can lead to collapse of internal defense mechanisms and appearance of psychical complains that put normal life in disorder [2][3][4][5]. ...
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It is known today that psycho-trauma and PTSD cause different levels of mental and social dysfunction. Human spirituality and capacity to meet further life diffi culties become severely damaged. There is wide accepted attitude today that in holistic approach in process of healing PTSD and psycho-trauma is necessary to include other professionals from community resource regarding needs of trauma victims. In Bosnia and Herzegovina after very severe war (1992-1995) as mental health professionals, we are faced with increasing number of different mental health disorders as result of severe trauma experiences. Regarding community based care orientation it is necessary to include and religion professionals. According national and religious background of majority of our population in Tuzla Canton that is Muslim, we meet spiritual needs of our clients as needs for Islamic explanation of life and death meaning. Our clients need to talk about spiritual issues in daily therapy and to practice daily religious rituals. Regarding that in this paper we tried to interface Islamic principles and it's beneficial toward psycho-trauma and PTSD as well as Muslim perspectives in attempt to apply spiritual practice in therapeutic tools for better efficacy in spiritual healing of mental dysfunction's of believers who survived severe trauma, especially war trauma.
... In wider sense, it pertains to any transfer of distress from someone who experiences trauma to those in his vicinity, and includes a wide range of distress manifestations (22). The researches show that the way parents handle trauma and symptoms of traumatic reactions influence the psychological development of child and the way the child respond (cope) to internal and external stress factors (11,12). Psychopathological symptoms at children of the veterans suffering from PTSD occur as a result of interaction between different biological, psychological, environmental factors and age, and may be manifested at psychological, behavioral, somatic and cognitive plan (23). ...
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Introduction Behavioral problems and emotional difficulties at children of the veterans of war with post-traumatic stress disorder (PTSD) have not been researched entirely. In our country, which has a lot of persons suffering from some psychological traumas, this trauma seems to continue. Aim The aim of this study was to determine the exposure, manifestations of behavioral problems and emotional difficulties at children and early adolescents, whose fathers were the veterans of war demonstrating post-traumatic stress disorder symptoms. Respondents and methods The analyzed group comprised 120 school age children (10-15 years of age), whose parents/fathers were the veterans of war. The children were divided into two groups, and each group into the following two age sub-groups: 10-12 (children) and 13-15 (early adolescents) according to PTSD presence at their fathers – veterans of war. PTSD symptoms at fathers, veterans of war, were assessed using the Harvard Trauma Questionnaire–Bosnia and Herzegovina version and MKB-10 – audit of criteria. To assess the behavioral problems of children, the Child Behavior Checklist for parents was used, and to evaluate the neuroticism at children Hanes–Scale of neuroticism-extraversion was used while the depression level was evaluated using the Depression self-rating scale (DSRS). To analyze the obtained results, SPSS 17 program was used. The value p <0. 05 is considered significant. Results Children of fathers, the veterans of war, demonstrating the PTSD symptoms show more problems in activity, social and school conduct as well as in symptoms of behavioral problems compared to the children whose fathers do not demonstrate the PTSD symptoms (p<0. 001). Children of the war veterans demonstrating the symptoms of the post-traumatic stress disorder show significant difference at neuroticism sub-scales (p<0.001). Negative correlation between PTSD and activity, social and school conduct has been determined (p <0. 01), while positive correlation was determined between PTSD of war veterans with symptoms and neuroticism at children (p <0. 01). Depression symptoms are found at 17.5% children, while 28.3% are in the risky group and the girls demonstrate higher depression level. Conclusion Children and early adolescents of fathers – veterans of war with post-traumatic stress disorder show significant differences in competencies, behavior, emotional difficulties and neuroticism. Significant correlation was found between psychopathology of parents – fathers the veterans of war and their children. Impact of psychological conditions of fathers – the veterans of war with post-traumatic stress disorder to children is strong and they represent a significant risky group for development of mental disorders.
... In wider sense, it pertains to any transfer of distress from someone who experiences trauma to those in his vicinity, and includes a wide range of distress manifestations (22). The researches show that the way parents handle trauma and symptoms of traumatic reactions influence the psychological development of child and the way the child respond (cope) to internal and external stress factors (11,12). Psychopathological symptoms at children of the veterans suffering from PTSD occur as a result of interaction between different biological, psychological, environmental factors and age, and may be manifested at psychological, behavioral, somatic and cognitive plan (23). ...
... Numerous authors addressed the problems of traumatized veterans and their families (3,4,5). After the war in Bosnia and Herzegovina, where there are still plenty of traumatized persons (6,7), psychological trauma has continued in some way (8,9,10). Post-traumatic stress disorder significantly influences general health of individual and decreases his functionality at family, social and work level (11)(12)(13). ...
While individual analytic therapy is still in its early stages of development, group analytic therapy and group psychotherapy in general are considerably advanced in comparison to other talking therapies, and are often used in healthcare settings and in private practice. All forms of psychotherapy offered in healthcare institutions are covered by health insurance. Most activities related to providing psychotherapy or undergoing training in various therapeutic modalities are not regulated by adequate laws or other regulations, nor does a definitive registry of psychotherapists exist. A majority of psychotherapists in healthcare institutions are (neuro)psychiatrists, but other helping professions are also often involved in providing therapies, with psychologists usually preferring cognitive-behavioural therapy.
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Background: Coronavirus disease 2019 (COVID-19), like any other pandemic, has imposed an unprecedented threat to physical and mental health to all nations, worldwide. There is no enough evidence in the literature in this area. The present study has been done to explore the organization of psychiatric services in Bosnia and Herzegovina (BH) to meet mental health needs of BH citizens during the particular restrictive measures caused by COVID-19 pandemic. Materials: This online survey has been done for BH psychiatric institutions. Data were collected from psychiatric institutions in the mental health network of BH. A total of 38 complete responses have been received. Results: Of 38 study participants, three were the departments of psychiatry in university clinical centers, two were psychiatric hospitals, four were psychiatric wards in general hospitals, 27 were community mental health centers, and two were institutes for alcoholism and drug addiction. During the pandemic, all services functioned on a reduced scale, adhering to measures to protect and self-protect both staff and service users. Protective equipment was provided to staff in some institutions in a timely and complete manner and in some in an untimely and incomplete manner. Consultative psychiatric examinations were mainly performed through telephone and online, where it exists as a standard patient monitoring protocol. The application of long-acting antipsychotics was continuous with adherence to restricted and protective measures. In opiate addiction replacement therapy services, substitution therapy was provided for a longer period to reduce frequent contacts between staff and patients. Individual and group psychotherapy continued in reduced number using online technologies, although this type of service was not administratively regulated. An initiative has been given to regulate and administratively recognize telepsychiatry by health insurance funds in the country. A number of psychological problems associated with restrictive measures and fear of illness have been reported by patients as well as by the professionals in mental healthcare teams. There were no COVID-19-positive patients seeking help from institutions that responded to the questionnaire. In one center, infected people with COVID-19 from abroad sought help through the phone. Only one involuntary hospitalization was reported. The involvement of mental health professionals in the work of crisis headquarters during the design of the COVID-19 pandemic control measures varies from satisfactory to insufficient. Education of staff, patients, and citizens was regular with direct instructions through meetings, press, and electronic media. Conclusions: During the COVID-19 pandemic in BH, all psychiatric services functioned on a reduced scale, adhering to measures to protect and self-protect staff and service users. All patients who asked for help have been adequately treated in direct inpatient or outpatient mental healthcare or online, despite telepsychiatric services not being recognized in health system in BH. There were neither infected patients nor staff with COVID-19 in the psychiatric institutions who responded in this research. A large-scale, multicenter study needs to be performed to get a broader picture and to guide us for future better service planning and delivery.
Conference Paper
رخداد سوانح طبیعی باعث تجربه سطحی از تروما در مقیاس فردی و جمعی در جامعه بازماندگان می¬گردد. ترومای شدید پس از نابودی روان انسان¬ها، اعتقادات مذهبی و معنویت را به طور کامل مختل می¬کند. تحقیق حاضر سعی دارد، چگونگی عملکرد فعالیت مذهبی نماز خواندن و نیایش در مساجد را از منظر اسلام و بر بنیان تئوری¬های مطرح، در جهت بازتوانی مجدد تشریح کند. بر اساس یافته¬های تحقیق فعالیت مذهبی نماز خواندن به صورت فردی سبب کسب و حفظ ثبات ذهنی و در قالب جماعت منجر به ادراک از حمایت اجتماعی و معناسازی می¬گردد. در این راستا فضای مسجد به عنوان مکان حمایت¬گر این فعالیت با ویژگی¬ها و فلسفه ایجابی خاص خود به واسطه عدالت محیطی، بقا و امنیت کالبدی و تزیینات اسلامی تداعی¬کننده طبیعت، در بازتوانی تاب¬آور اجتماعی- روانی پس از سوانح نقش مهمی دارد. مقاله نتیجه می¬گیرد در موقعیت رخداد سوانح بقا کالبدی، احیا عملکرد مساجد محلات شهری و تسریع برگزاری نمازهای جماعت در این فضاها بر التیام اجتماعی- روانی تروما تاثیرگذار خواهند بود.
This chapter tries to offer an image of clinical psychology in Eastern Europe, by looking at the history of the domain, the current work settings, and training and licensing systems. As nowadays the field of clinical psychology is quite divergent among Eastern European countries, the beginning of psychology as a science and its development under the communist regime were somewhat similar. The scientific domain of psychology was introduced in Eastern Europe by former students and collaborators of Wilhelm Wundt, who started their own laboratories in their native countries (e.g., Russia, Poland, Romania, Bulgaria). Following the installation of the communist regime, psychology was for many years subsumed to soviet psychology, with negative consequences like limiting access to western works, or censuring citation of western authors, which created a wide knowledge gap between Eastern Europe and western society. The domain of clinical psychology specifically was also affected by the negative view of mental illness prevalent in Eastern European countries, particularly enforced in the Soviet Union. Given the view that mental illness was believed to be either caused by the perception of social inequalities, which supposedly had been solved by communism, or by chemical imbalances, which were subject to medical treatment alone, there was little room for psychologists to approach mental health issues. This view still persists to this day in Eastern Europe, with psychologists still holding a limited role in assessing and treating mental conditions.
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Mental health is not considered only as absence of mental disorders, but rather as the achievement of higher standards of available psychical potentials. True devotion and obedience to The God give the one a huge and incredible strength, constant source of spiritual emotional and moral energy, which is of help in resisting destructive and slavery attacks of the environment and its materialistic-consuming tendencies, as well as social and mental disruption. According to the opinion of numerous worldwide recognized mental health experts, humankind of today is confronted with a number of problems, which are the consequence of spiritual and moral-ethical degradation of human being. Therefore, religiosity became the field of interest of mental health researchers. The results of new studies undoubtedly indicate beneficial effects of religion on life and mental health in humans. Religiosity reduces tendencies for risky behaviour, impulsive reactions and aggression; it corrects tendencies towards psychopathic and paranoid behaviour, reduces converse, depressive and schizoid tendency, and provides successful overcome of emotional conflicts. In comparison to low-religious adolescents, the factors such as inner conflicts, frustration, fear, anxiety, psychological trauma, low self-esteem, unbalance of psychical homeostasis, emotional instability, and negative psychical energy are less present in highly religious adolescents and neutralized in a healthier and more efficient way. Beneficial impact of religion on mental health derives from precise cognitive-behavioural patterns, which provide a clear life orientation, solid basis and safe frames for personality development, assuring human to be continually on the way to achieve its own generic essence and reach its own maturity and self-actualization.
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After the war in Bosnia-Herzegovina, mental illness is very prevalent. With little knowledge about mental health, the stigma of mental illness is still pervasive in many communities. To combat this prejudice, we describe mental health promotion strategies which can empower individuals and educate the communities in which they live.
The 1992-1995 war in Bosnia-Herzegovina caused much devastation in that region of the world. This article describes the themes and issues that emerged from information gained from interviews with Bosnian professionals through a project entitled “Trauma and Reconciliation in Bosnia-Herzegovina,” funded by the National Research Council. The current issues facing Bosnia include complex trauma-related and post-war issues, lack of coordination in professional services, limited outcome research and program evaluation, and the need for services for children and families. Recommendations and implications for marriage and family therapy are included.This project was funded through a grant from the National Research Council Young Investigators Program, National Academy of Sciences, Washington, DC, USA.
Psychiatric services in Bosnia-Herzegovina before the war disaster was fairly developed and one of the best organized services amongst the republics of the former Yugoslavia. The psychiatric care system was based on psychiatric hospitals and small neuropsychiatric wards within general hospitals, accompanied by psychiatric services in health centers. The onset of war in B&H brought devastation and destruction in all domains of life, including the demolition and closing of numerous traditional psychiatric institutions, together with massive psychological suffering of the whole civilian population. Already during the war, and even more so after the war, the reconstruction and reorganization of the mental health services was undertaken. The basis of mental health care for the future is designed as a system where majority of services is located in the community, as close as possible to the habitat of the patients. The key aspect of the system of the comprehensive health care is primary health care and the main role is assigned to family practitioners and mental health professionals working in the community. Large psychiatric institutions were either closed or devastated, or have their capacities extensively reduced. There will be no reconstructions or reopening of the old psychiatric facilities, nor the new ones will be built. The most integrated part of the psychiatric system are the Community based mental health centers. Each of these centers will serve a particular geographic area. The centers will be responsible for prevention and treatment of psychiatric disorders, as well as for the mental health well being. Chronic mental health patients without families and are not able to independently live in the community will be accommodated in designated homes and other forms of protected accommodation within their communities. The principal change in mental health policy in B&H was a decision to transfer psychiatric services from traditional facilities into community, much closer to the patients. Basic elements of the mental health policy in B&H are: Decentralization and sectorization of mental health services; Intersectorial activity; Comprehensiveness of services; Equality in access and utilization of psychiatric service resources; Nationwide accessibility of mental health services; Continuity of services and care, together with the active participation of the community. This overview discusses the primary health care as the basic component of the comprehensive mental health care in greater detail, including tasks for family medicine teams and each individual member. 1. Comprehensive psychiatric care is implemented by primary health care physicians, specialized Centers for community-based mental health care, psychiatric wards of general hospitals and clinical centers in charge of brief, "acute" inpatient care; 2. Primary mental health care is implemented by family practitioners (primary care physicians) and their teams; 3. Specialized psychiatric care in community is performed professional teams specialized mental health issues' within Mental health centers in corresponding sectors; 4. A great deal of relevance is given to development of confidence and utilization of links between primary health care teams and specialized teams in Mental health centers and psychiatric in patient institutions; 5. Psychiatric wards within general cantonal hospitals, departments of psychiatric clinics in Sarajevo, Tuzla, and Mostar, and Cantonal Psychiatric hospital in Sarajevo (Jagomir) shall admit acute patients as well as chronic (with each new relapse). Treatment in these facilities is brief an patients are discharged to return to their homes, with further treatment referral to their family practitioner or designated Mental health center; 6. Chronic mental patients with severe residual impairment in social, psychological, and somatic functioning, shall live in the community with their families or independently. Those chronic patients without families and economic and other resources to live independently shall be placed in supervised Homes in the communities where they live. The above delineated strategy of mental health care program in B&H has several fundamental and specific objectives, among which the most important are: Reduction of incidence and prevalence of some mental disorders, particularly war stress-related disorders and suicide; Reduction of level of functional disability caused by mental disorders through improvement of treatment and care of individuals with mental health problems; Improvement of psychosocial well being of people with mental health problems, through implementation of comprehensive and accessible service for community mental health care; and Respect of basic human rights of individuals with mental health disabilities. The program has been updated since 1996, after the two-year pilot program. The main goals for current two- and five-year period are: Implement the mental health care reform program by launching all 38 Mental health centers in the Federation of BiH by 2002; Complete the 10-day education and re-education of at least 50% of all professionals employed in mental health services in FB&H by 2002; and Achieve that 80 percent of all mental health problems are treated by family medicine teams (primary care practitioners) and specialized mental health services (Community mental health care centers) by 2005.
Mental Health Atlas, Bosnia and Herzegovina Available at
World Health Organization (2005) Mental Health Atlas, Bosnia and Herzegovina. Available at MentalHealth/Files/BA_Mental_Health_Profile.pdf (last accessed November 2008).
Early psychosocial interventions for war-affected populations
  • K De Jong
  • R Stickers
de Jong, K. & Stickers, R. (2003) Early psychosocial interventions for war-affected populations. In Early Interventions in Emergencies (eds R. Orner & U. Schnyder), pp. 184-192. Oxford University Press.