Mental health under war conditions during the 1991-1995 war in the former Yugoslavia.

Abstract

If this war were a "peace time disaster" it is estimated that more than one million people would be in need of assistance due to mental health issues. The estimated helping capacity, however, can cover only a small proportion of the need. This imbalance may create a severe threat to the mental health of the war-torn population in a medium- and long-term perspective. Complications related to war-trauma-induced stress disorders may give rise to significant increases in alcohol and drug abuse, domestic and criminal violence, suicides, homicides and chronic mental illness. This article outlines the international efforts to include psychosocial and mental health interventions as part of the emergency assistance programme. Special emphasis is directed at the development of the new WHO Regional Model on Mental Health. The model is a coordinated set of mental health activities for a defined geographical area with a population of 300,000-400,000 inhabitants. The key elements are: coordination, collection of background data ("war-time epidemiology"), capacity building and self-empowerment of local professionals at all levels, as well as a community-oriented approach to mental health care and primary health care. A new structure to achieve sustainability and continuity of preventive mental health interventions, the European University Centre for Mental Health and Human Rights, is proposed for the medium- and long-term perspective of assistance.