The Republic of Croatia is in central Europe, on the Mediterranean. A large majority of its 4 440 000 inhabitants are Croats (89.6%). The main religion is Roman Catholicism (88%). Sixteen per cent of the population is aged over 65 years. Croatia was a part of Yugoslavia after the Second World War until 1991, when Croatia declared independence. Following the declaration, Croatia was attacked by the Yugoslav army and by Serbia and suffered a devastating war (1991–95). The transition had consequences for mental health, for example a dramatic rise in the prevalence of post-traumatic stress disorder, especially among soldiers. The majority of soldiers received appropriate psychiatric treatment; there has, however, been an increase in claims motivated by secondary gain, as a result of government policy.

Croatia is a member of the United Nations, the Council of Europe and the North Atlantic Treaty Organization (NATO), and has applied to join the European Union (EU). The EU application is expected to help Croatia shift the focus of its mental health system to community psychiatry.

Mental health policy and legislation

Mental health policy is a construct of the overall health policy, under legislation from the Croatian Ministry of Health and Welfare (CMHW). Currently, two initiatives to define mental health policy are being developed by the CMHW and the Croatian National Institute of Public Health (CNIPH): the Croatian Alcohol Action Plan (2006) and the National Mental Health Strategy (2009).

The legislation stipulates that mental healthcare is to be provided at primary, secondary and tertiary levels. The primary level comprises general practitioners (GPs), school medicine specialists and mental health professionals in mental health centres and in public health institutes. The secondary level comprises mental health professionals, mainly psychiatrists. The tertiary level – the prevention of mental illness, the promotion of mental health, epidemiology and mental health statistics – is the reponsibility of mental health professionals, the Croatian Institute for Mental Health and the CNIPH, and incorporates the Croatian Psychosis Registry, the Croatian Suicide Registry, and the Croatian National Registry of Treated Psychoactive Drug Addicts.

Other potential creators of the mental health policy, such as mental health professionals and mental service users’ organisations, are only marginally involved.