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M. Miković

Društvene mreže:

D. Zaviršek, M. Ajduković, I. Vidanovic, M. Miković, Davina Lakinska, Suzana Bornarova

Within the brooder overview of the history of social work education in the Balkan region the history of the social work in Croatia was described in detailed. Its development was described in three phases. Phase 1 from 1952 to 1971 described education for social workers exclusively on the colleague level. Phase 2 from 1972 to 1981 described parallel system of education for social workers on colleague and university level. Phase 3 from 1982 up to now described development of university program of social work within the Faculty of Law University of Zagreb.

I. Cerić, S. Loga, O. Sinanović, Z. Cardaklija, G. Čerkez, L. Jacobson, S. Jensen, M. Reali, L. Toresini et al.

Psychiatric services in Bosnia-Herzegovina before the war disaster was fairly developed and one of the best organized services amongst the republics of the former Yugoslavia. The psychiatric care system was based on psychiatric hospitals and small neuropsychiatric wards within general hospitals, accompanied by psychiatric services in health centers. The onset of war in B&H brought devastation and destruction in all domains of life, including the demolition and closing of numerous traditional psychiatric institutions, together with massive psychological suffering of the whole civilian population. Already during the war, and even more so after the war, the reconstruction and reorganization of the mental health services was undertaken. The basis of mental health care for the future is designed as a system where majority of services is located in the community, as close as possible to the habitat of the patients. The key aspect of the system of the comprehensive health care is primary health care and the main role is assigned to family practitioners and mental health professionals working in the community. Large psychiatric institutions were either closed or devastated, or have their capacities extensively reduced. There will be no reconstructions or reopening of the old psychiatric facilities, nor the new ones will be built. The most integrated part of the psychiatric system are the Community based mental health centers. Each of these centers will serve a particular geographic area. The centers will be responsible for prevention and treatment of psychiatric disorders, as well as for the mental health well being. Chronic mental health patients without families and are not able to independently live in the community will be accommodated in designated homes and other forms of protected accommodation within their communities. The principal change in mental health policy in B&H was a decision to transfer psychiatric services from traditional facilities into community, much closer to the patients. Basic elements of the mental health policy in B&H are: Decentralization and sectorization of mental health services; Intersectorial activity; Comprehensiveness of services; Equality in access and utilization of psychiatric service resources; Nationwide accessibility of mental health services; Continuity of services and care, together with the active participation of the community. This overview discusses the primary health care as the basic component of the comprehensive mental health care in greater detail, including tasks for family medicine teams and each individual member. 1. Comprehensive psychiatric care is implemented by primary health care physicians, specialized Centers for community-based mental health care, psychiatric wards of general hospitals and clinical centers in charge of brief, "acute" inpatient care; 2. Primary mental health care is implemented by family practitioners (primary care physicians) and their teams; 3. Specialized psychiatric care in community is performed professional teams specialized mental health issues' within Mental health centers in corresponding sectors; 4. A great deal of relevance is given to development of confidence and utilization of links between primary health care teams and specialized teams in Mental health centers and psychiatric in patient institutions; 5. Psychiatric wards within general cantonal hospitals, departments of psychiatric clinics in Sarajevo, Tuzla, and Mostar, and Cantonal Psychiatric hospital in Sarajevo (Jagomir) shall admit acute patients as well as chronic (with each new relapse). Treatment in these facilities is brief an patients are discharged to return to their homes, with further treatment referral to their family practitioner or designated Mental health center; 6. Chronic mental patients with severe residual impairment in social, psychological, and somatic functioning, shall live in the community with their families or independently. Those chronic patients without families and economic and other resources to live independently shall be placed in supervised Homes in the communities where they live. The above delineated strategy of mental health care program in B&H has several fundamental and specific objectives, among which the most important are: Reduction of incidence and prevalence of some mental disorders, particularly war stress-related disorders and suicide; Reduction of level of functional disability caused by mental disorders through improvement of treatment and care of individuals with mental health problems; Improvement of psychosocial well being of people with mental health problems, through implementation of comprehensive and accessible service for community mental health care; and Respect of basic human rights of individuals with mental health disabilities. The program has been updated since 1996, after the two-year pilot program. The main goals for current two- and five-year period are: Implement the mental health care reform program by launching all 38 Mental health centers in the Federation of BiH by 2002; Complete the 10-day education and re-education of at least 50% of all professionals employed in mental health services in FB&H by 2002; and Achieve that 80 percent of all mental health problems are treated by family medicine teams (primary care practitioners) and specialized mental health services (Community mental health care centers) by 2005.

M. Miković, K. Halilovic

The consequences of the pathology of war on the family and society's dependence upon the family are examined from a functional point of view. The distinctive role of the mother in relation to care and protecting a cult of civil taste is addressed. To conclude, the reasons multi-national families in comparison to single-national families showed more resilience during the war are formulated

L'A. dresse le bilan de la guerre de Bosnie Herzegovine. Il estime que les enfants ont ete durement frappes par ce conflit. De nombreux enfants ont trouve la mort ou ont ete blesses. Bon nombre d'entre eux sont devenus orphelins. Sur le plan de la sante, de nombreux enfants souffrent de stress, de troubles du sommeil, de traumatismes psychologiques. L'A. se demande dans quelle mesure les enfants peuvent s'adapter aux conditions de vie liees au contexte de guerre. Il s'efforce d'evaluer les consequences a long terme de la guerre sur la vie des enfants. Il insiste sur le fait que des programmes de prise en charge des orphelins doivent etre mis en place en Bosnie Herzegovine. Il evoque la situation des enfants deplaces ou celle des enfants refugies dans les differentes regions du globe. Il s'interroge quant a leur faculte a s'adapter a de nouvelles conditions de vie

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