Un système de santé mentale de proximité

A significant progress has been made in mental health care reform in BiH since 1996, focusing on the development of out-patient mental health services at the Community level. However, social exclusion and discrimination still remain key issues affecting the quality of life of people with mental health problems. A stronger focus on preventive care and on identifying early symptoms and preventing mental illness from becoming severe and disabling is necessary. Specific skills of mental health service providers for psychotherapy, occupational therapy, and work with juvenile patients and victims of family violence are lacking.

To contribute to an improved general well-being of people with mental disorders and of those at risk of developing mental health problems in BiH.

Direct project beneficiaries are about 500 mental health professionals, primarily those working in 68 Community Mental Health Centers throughout the country. The project will support them in gaining required skills and knowledge and in improving their working environments. Beneficiaries of the project are also the health authorities and mental health institutions, whose capacities for effective and efficient management of community-based mental health services will be enhanced. End beneficiaries are persons with mental disorders and their families and those at risk of developing MH problems, belonging to disadvantaged and vulnerable groups.

Intermediary outcomes:

1. Community-based mental health services are managed more effectively and service quality is continuously improved, based on evidence;

2. Persons with mental disorders and those at risk of developing such disorders have access to mental health services of increased quality and scope in their communities;

3. Discrimination against persons with mental health disorders in the communities has decreased.

Principaux résultats attendus:  

- Established mental health standards of practice and a quality monitoring system

- Established information system for mental health monitoring, data collection and analysis

- Improved skills of mental health professionals to provide quality services (case management, occupational and work therapy, psychotherapy)

- Enhanced mental health outreach services

- Mental health infrastructure improved

- Implemented community anti-stigma programs

- Increased capacities of user associations for social inclusion interventions

Principaux résultats antérieurs:  

The policy and regulatory framework for mental healthcare in BiH has been brought in line with European standards. A set of indicators for monitoring the population's mental health was developed. The scope of available mental health services increased: 88% of nurses are now working independently with patients (vs. previous 29%), and the case management approach was introduced in 66% of Community mental healthcare centres, benefiting 1'282 persons with severe mental disorders. Quality of services has been improved and the hospital referrals rate of patients has decreased by 30% (sample of 10 out of 68 Centers).

Entity and cantonal Ministries of Health; Entity Public Health Institutes and Agencies for Accreditation and Quality in Health; professional associations of nurses, psychiatrists, psychologists, and social workers; associations of users of mental health services.

Synergies with other SDC-funded health projects in BiH: Strengthening Nursing Project (continuous education of nurses and nursing standards in mental heaith); Reducing Health Risk Factors Project (reduction of alcohol consumption and promotion of healthy life styles among persons with mental disorders); Promoting Healthy Lifestyles among Young Men and Women (promoting non-violent life styles among youth).The project will also coordinate its efforts with the World Bank, UNICEF, UNFPA, the Government of Denmark and lOM.

Phase 2 01.03.2014 - 28.02.2018   (Completed)