[Reconstruction of mental health services in the Federation of Bosnia-Herzegovina].

The war in Bosnia and Herzegovina has caused severe suffering of the population, and left behind destruction and misery. Hundreds of thousands were killed, ten thousands were severely injured, and almost the whole population has endured severe psychological traumas. The consequences today are numerous stress related psychical disorders, and especially PTSD. The war has almost destroyed the system of psychiatric services, and lead to lack of professional staff. Because of this, after the war, Federal Ministry of Health of Bosnia and Herzegovina has decided to carry out a complete reconstruction of psychiatric services based on new principles. Comprehensive care for improvement of mental health; prevention of mental illness, treatment and rehabilitation of mentally ill, should be transferred from institutions into the community. Consequently Ministry of Health have designed 38 Community Mental Health Centers in the Federation of Bosnia and Herzegovina in connection with already existing Primary Health Care centers (Dom zdravljas). Each of these centers is responsible for mental health in general within a catchment area of 50,000-80,000 inhabitants. A network of Community Mental Health Centers has started to operate. An efficient and useful training of the staff going to work in these centers have been carried out. Nevertheless, there is still significant resistance towards this new approach to mental health services and treatment of people with mental illness in the community. However, many problems related to this new program of community psychiatry have been identified and are under consideration.