BALKANS: Serbia Introduces Mental Health Strategy

By Vesna Peric Zimonjic Reprint | | Print |

Vesna Peric Zimonjic

BELGRADE, Feb 14 2007 (IPS) - Serbia is to implement a 10-year plan to improve mental health that declined for many in recent years of harsh isolation and transition into a market economy.

“Mental health problems were something experts have warned about more than 10 years ago, particularly where young people were concerned, but it is only now that something can be done,” Dr Vojislav Curcic told IPS.

Dr Curcic heads the psychiatry department of the elite Dragisa Misovic hospital in Belgrade, and was involved in the five-year research that led to the creation of the Strategy for Mental Health project, now adopted by the government.

The plan provides for complete reconstruction of seven psychiatry hospitals at a cost of 15 million dollars, and introduction of a psychiatric centre for 200,000 people.

“This will take years, but it’s of basic importance for this nation,” Curcic said. Serbia has a population of 7.5 million.

The study based on statistics from health institutions and field research that led to the Strategy for Mental Health showed that a third of the population aged 15-24 has some mental disorders.

“This comes as no surprise, as people in this age group have spent practically their whole lives under traumatic circumstances,” Curcic said. “And they should be the basis of this society in the years to come.”

The disintegration of former Yugoslavia that began with years of wars after 1991 led to a complete breakdown of society as it used to be.

Once prosperous Serbia witnessed a collapse of the economy after 1992 when strict international sanctions were imposed due to Belgrade’s role in the wars. Economic paralysis led to mass unemployment, a flourishing black market, and crime.

In 1999, Serbia survived 11 weeks of daily bombing by the North Atlantic Treaty Organisation (NATO) due to the repressive politics of Belgrade against ethnic Albanians in Kosovo province.

Apart from destruction of roads, bridges, power production and distribution systems, and some 1,500 deaths, the bombing left psychological scars on many.

“Two years after the bombing ended (in 2001) our statistics showed that 27 percent of people suffered from post-traumatic stress syndrome (PTSS),” Dr Milan Milic from the Institute of National Health said at a press conference on the new project. “However, in a traditional society such as this one, most thought they could overcome the problem on their own, which was not the case.”

On the one hand, experts agree, Serbs are reluctant to seek psychiatric health treatment due to the conservative view that it is “a shame and a sign of weakness,” as Milic puts it. On the other, many took to self-cure in the form of freely available tranquillisers that could be obtained over the counter in the 1990s.

The introduction of strict rules on drugs sale after the change of regime in 2000 forced many to turn to doctors and ask for help.

However, statistics still show that, although tranquillisers and sedatives can be obtained supposedly on medical prescription only, almost half of the adult population uses them daily. Pharmaceutical statistics say three million tablets of Bensedine, the most popular tranquiliser, are consumed daily.

“Depression is the second biggest chronic health problem in the population, following cardiac illnesses,” Dr Milic said. “It is the price of accumulated stress. For years, people woke up hoping for something better. That caused uncertainty, anxiety, fear and depression.”

Transition to the market economy, immediately after the harsh 1990s and change of regime in 2000, additionally complicated life, experts say.

“There came a new round of layoffs, and doubts over any better future,” Dr Curcic says. “But I think that the crisis has peaked, and things will start returning to normal in the coming years.”

The mental health research study has shown that the old are also particularly vulnerable. Serbia is a country of the old; a third of its population is above the age of 60. Official statistics put the average age of a Serb at almost 41, with extremely low birth rates (1.3 children per family).

“The old feel neglected, not needed and depression becomes a daily routine for many,” Dr Milic said.

The new strategy provides for new hospitals but also for open treatment. Patients will be treated in their natural surroundings, rather than at psychiatric institutions, and general practice doctors will be educated to treat mild disorders.

Another innovation will be construction of “protected homes” where patients who need longer help will be treated through work and other therapy, rather than being confined for years.

“Many psychiatric patients were left in hospitals for years and many did not have a place to go once their treatment was completed,” Milic said. “Protected homes, specially built for them, will mean the best next thing to normal life for those people.”