Pravni i organizacioni okvir za osnivanje službi za zaštitu mentalnog zdravlja u zajednici
Legal and organizational framework for the establishment of services for the protection of mental health in the community

Author(s): Marta Sjeničić
Subject(s): Gender Studies, Psychology, Sociology, Health and medicine and law, Welfare services
Published by: Институт друштвених наука
Keywords: Mental health; Persons with mental disorders; Legal protection; Social care institutions
Summary/Abstract: The basis of the concept of mental health in the community is the idea that people with mental disorders are not excluded from society through long-term and repeated, sometimes lifelong hospitalizations in psychiatric hospitals or placement in in-patient social care institutions, but that help, treatment and rehabilitation are provided in the place of residence, in constant cooperation with the community. This concept implies the development of mental health services in the community, which should provide comprehensive treatment and protection to patients or users of social care services, in the environment in which they live, and which will be easily accessible to them and their families. In order to maximize the possible resocialization of mentally ill persons, the transfer of all positive functions of the institution to the community level is imposed, but without repeating their negative aspects. In achieving this goal, it is necessary to use all the potential of the community (Jović et al., 2016, 14). Since the process of resocialization also includes deinstitutionalization, it implies a gradual transfer of economic and human resources with fundamentally changed services for the protection of mental health and the simultaneous creation of centers for the protection of mental health in the community (Jović et al., 2016, 12). Therefore, it is necessary to transform institutions/facilities for inpatient accommodation (psychiatric hospitals, social care homes) into services in the community. The main reasons cited in the literature as motivators for this transformation are: that access to mental health services for people with long-term mental disabilities is much better when it comes to services in the community than in traditional psychiatric hospitals; community services are associated with greater user satisfaction and the level of satisfied needs; they achieve continuity and flexibility of care; it is possible to more often identify and treat early periods of crises and increase the level of treatment acceptance; community services better protect the human rights of people with mental disabilities and prevent their stigmatization; the results of services in the community are better when it comes to clinical symptoms, quality of life, housing stability, work rehabilitation; for acute psychoses, services in the community are more cost-effective than those in the hospital (although this cannot be generalized for all such patients); most patients who have switched from hospital treatment to community services have fewer negative symptoms, better social life and are more satisfied.

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