Clinical guidelines have been designed to lead to significant and consistent improvements in health care but are rarely fully implemented within healthcare services. The study involved a survey of staff at four Community Mental Health Teams, which aimed to assess their knowledge and use of both the psychological recommendations of the National Institute for Health and Clinical Excellence (NICE) guidelines for Depression and specifically of cognitive-behavioural therapy (CBT) based interventions. It also aimed to assess team members' clinical assessment skills and decision-making patterns when making recommendations about services for patients with depression. The results indicated that while over 90% of staff said they were using the NICE guidelines for Depression, less than 20% were very confident in using them. Most staff had knowledge about CBT and most (88%) would be very willing to refer to CBT but mentioned problems such as lack of resources and/or social problems affecting service delivery. Most staff were generally able to correctly identify the severity and type of depression. Despite this, some staff were making decisions that were not in accordance with the NICE recommendations. Reasons for these patterns are discussed.

Abbreviations:AOR = Areas of Responsibility IMC = International Medical Corps INGO = international non-governmental organization OSCE = Organization for Security and Co-operation in Europe WHO = World Health Organization Abstract Introduction: A professional understanding of disasters, paired with the need for health service development, can provide opportunities for the recovery and improvement of the health sector. Investment in training capacity ranks among the top priorities of a recovering health sector. The recovery and development of primary healthcare delivery systems has been implemented by various international and local health players in the aftermath of conflicts around the world. However, human resource development in the post-conflict environment has not been evaluated and/or published appropriately in the medical literature. Objective: In this retrospective, descriptive study, the authors describe the strategy and evaluate the effectiveness of a field-based training program for primary healthcare doctors implemented by the US-based international non-governmental organization, the International Medical Corps, after the conflict in Kosovo in 1999. Methods: A six-month, comprehensive education and training program on primary healthcare issues was delivered to 134 Kosovar primary healthcare physicians in 10 Kosovo municipalities in 1999 and 2000. Qualitative and quantitative data were collected. The qualitative methods included open-ended, semi-structured, key informant interviews, structured focus groups, and unstructured participant observations. The quantitative method was multiple-choice knowledge tests. Results: The education and training program proved to be culturally appropriate and well-accepted by local communities. The program met its overall objective to refresh the knowledge of primary care doctors on various primary healthcare issues and set the stage for further strengthening and development of primary health services and their required human resources in Kosovo. Conclusions:The comprehensive education and training of primary healthcare doctors in Kosovo was a feasible, much appreciated, and effective intervention implemented in a difficult post-conflict environment. This training was one of the early steps in the modernization of primary healthcare services in Kosovo. Later, primary health care was strengthened by the introduction of a Department of Family Medicine at the university, which includes a residency program. The intervention described in this study has the potential to be reproduced in other post-disaster environments, especially in resource-poor settings with long-time troubled health sectors in developing countries. O'Hanlon K: Post-disaster recovery: A case study of human resource development in the health sector in post-conflict Kosovo. Prehosp Disaster Med 2011;26(1):7-14. Post-Disaster Recovery Prehospital and Disaster Medicine Vol. 26, No. 1 12 Post-Disaster Recovery Prehospital and Disaster Medicine Vol. 26, No. 1

After a large-scale humanitarian disaster, 30–50% of victims develop moderate or severe psychological distress. Rates of mild and moderate mental disorders increase by 5–10% and severe disorders by 1–2%. Those with such disorders need access to mental healthcare. Primary care clinics are appropriate due to their easy accessibility and the non-stigmatising environment. There is a consensus among experts that the mental health effects of disaster are best addressed by existing services, that is, through capacity building rather than by establishing parallel systems. Mental health interventions in emergencies should begin with a clear vision for the long-term advancement of community services.

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