Abstract
In many economically struggling societies, forensic psychiatry is still in its initial developmental stages and thus forensic patients pose an ongoing challenge for the healthcare and juridical systems. In this article, we present the various issues and problems that arose when establishing the first forensic psychiatric institute in Kosovo – a country whose population has constantly been reported as suffering from a high psychiatric morbidity due to long-lasting traumatic experiences during the war of 1999. The implementation of a new forensic psychiatric institute in the developing mental healthcare system of Kosovo, still characterized by considerable shortages, required substantial effort on various levels. On the policy and financial level, it was made possible by a clear intent and coordinated commitment of all responsible national stakeholders and authorities, such as the Ministries of Health and Justice, and by the financial contribution of the European Commission. Most decisive in terms of the success of the project was capacity building in human resources, i.e., the recruitment and training of motivated staff. Training included essential clinical and theoretical issues as well as clearly defined standard operation procedures, guidelines, and checklists to aid daily routine work and the management of challenging situations.
Highlights
Most industrialized countries have established a structure for placing and treating mentally ill offenders in specialized facilities and services, either as a specialized sector within the healthcare system or more or less integrated into the overall scheme of psychiatric care
The purpose of this paper is to describe the preparation and implementation processes for that service in Kosovo and the issues and problems to be addressed when establishing a new forensic psychiatric institute in an economically struggling society characterized by a limited mental health care infrastructure and rudimentary experience in forensic psychiatry
The review of the state of Kosovo’s mental healthcare and forensic psychiatric care as part of the initial task is summarized in the Introduction and Starting point sections above
Summary
Most industrialized countries have established a structure for placing and treating mentally ill offenders in specialized facilities and services, either as a specialized sector within the healthcare system or more or less integrated into the overall scheme of psychiatric care. In many threshold countries or economically struggling societies, forensic psychiatry is still in its initial stages and poses an ongoing challenge for the healthcare and juridical systems and society in general. This is the case in Kosovo, where a process for establishing a new specialized service for mentally ill offenders – the first forensic psychiatric institute of the country – was initiated and included in the Kosovo mental health strategy for 2008–2013. The purpose of this paper is to describe the preparation and implementation processes for that service in Kosovo and the issues and problems to be addressed when establishing a new forensic psychiatric institute in an economically struggling society characterized by a limited mental health care infrastructure and rudimentary experience in forensic psychiatry
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