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3 results

  • Mental health services during the first wave of the COVID-19 pandemic in Europe: Results from the EPA Ambassadors Survey and implications for clinical practice

  • Part of
  • Martina Rojnic Kuzman, Simavi Vahip, Andrea Fiorillo, Julian Beezhold, Mariana Pinto da Costa, Oleg Skugarevsky, Geert Dom, Izet Pajevic, Alma Mihaljevic Peles, Pavel Mohr, Anne Kleinberg, Eka Chkonia, Judit Balazs, William Flannery, Ramune Mazaliauskiene, Jana Chihai, Jerzy Samochowiec, Doina Cozman, Goran Mihajlovic, Lubomira Izakova, Celso Arango, Philip Goorwod
  • Journal:
    European Psychiatry / Volume 64 / Issue 1 / 2021
    Published online by Cambridge University Press:
    09 June 2021, e41
    • Article
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      • Open access
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  • Background

    The COVID-19 pandemic caused an unprecedented worldwide crisis affecting several sectors, including health, social care, economy and society at large. The World Health Organisation has emphasized that mental health care should be considered as one of the core sectors within the overall COVID-19 health response. By March 2020, recommendations for the organization of mental health services across Europe have been developed by several national and international mental health professional associations.

    Methods

    The European Psychiatric Association (EPA) surveyed a large European sample of psychiatrists, namely the “EPA Ambassadors”, on their clinical experience of the impact of COVID-19 pandemic on the treatment of psychiatric patients during the month of April 2020 in order to: a) identify and report the views and experiences of European psychiatrists; and b) represent and share these results with mental health policy makers at European level. Based on the recommendations issued by national psychiatric associations and on the results of our survey, we identified important organisational aspects of mental health care during the peak of the first wave of the COVID-19.

    Results

    While most of the recommendations followed the same principles, significant differences between countries emerged in service delivery, mainly relating to referrals to outpatients and for inpatient admission, assessments and treatment for people with mental disorders. Compared to previous months, the mean number of patients treated by psychiatrists in outpatient settings halved in April 2020. In the same period, the number of mentally ill patients tested for, or developing, COVID-19 was low. In most of countries, traditional face-to-face visits were replaced by online remote consultations.

    Conclusions

    Based on our findings we recommend: 1) to implement professional guidelines into practice and harmonize psychiatric clinical practice across Europe; 2) to monitor the treatment outcomes of patients with COVID-19 and pre-existing mental disorders; 3) to keep psychiatric services active by using all available options (for example telepsychiatry); 4) to increase communication and cooperation between different health care providers.

  • Bosnia and Herzegovina

  • from Europe
    • By Osman Sinanovic, Department of Neurology, University of Tuzla, Bosnia and Herzegovina, Esmina Avdibegovic, Department of Psychiatry, University of Tuzla, Bosnia and Herzegovina, Mevludin Hasanovic, Department of Psychiatry, University of Tuzla, Bosnia and Herzegovina, Izet Pajevic, Department of Psychiatry, University of Tuzla, Bosnia and Herzegovina, Alija Sutovic, Department of Psychiatry, University Clinical Centre Tuzla, Medical Faculty, University of Tuzla, 75000 Tuzla, Bosnia and Herzegovina, Slobodan Loga, Department of Psychiatry, University of Sarajevo, Bosnia and Herzegovina, Ismet Ceric, Department of Psychiatry, Clinical Hospital Centre Sarajevo, Medical Faculty, University of Sarajevo, 71000 Sarajevo, Bosnia and Herzegovina
  • Edited by Hamid Ghodse
  • Book:
    International Perspectives on Mental Health
    Published online:
    02 January 2018
    Print publication:
    01 June 2011, pp 283-287

  • Summary

    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 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.

    Mental health policy and legislation

    Healthcare systems in BH are regulated basically by the entities’ different laws on healthcare and on health insurance. 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 administrations 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 voluntary 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 developing other services in the community, a multidisciplinary approach and teamwork, as well as cooperation between sectors.

  • The organisation of mental health services in post-war Bosnia and Herzegovina

  • Part of
  • Osman Sinanovic, Esmina Avdibegovic, Mevludin Hasanovic, Izet Pajevic, Alija Sutovic, Slobodan Loga, Ismet Ceric
  • Journal:
    International Psychiatry / Volume 6 / Issue 1 / January 2009
    Published online by Cambridge University Press:
    02 January 2018, pp. 10-12
    Print publication:
    January 2009
    • Article
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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 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 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.