A Family Approach to Severe Mental Illness in Post–War Kosovo

Abstract

This study describes the effects of a psychoeducational multiple-family group program for families of people with severe mental illness in post-war Kosovo that was developed by a Kosovar-American professional collaborative. The subjects were 30 families of people with severe mental illnesses living in two cities in Kosovo. All subjects participated in multiple-family groups and received family home visits. The program documented medication compliance, number of psychiatric hospitalizations, family mental health services use, and several other characteristics, for the year prior to the groups and the first year of the groups. The families attended an average of 5.5 (out of 7) groups, and 93% of these families attended four or more meetings. The uncontrolled pre- to post-intervention comparison demonstrated decreases in medication non-compliance and hospitalizations, and increases in family mental health service use. The program provided training for mental health professionals, led to policy change in the Ministry of Health, and resulted in dissemination to other community mental health centers. This study provides preliminary evidence that a collaboratively designed and implemented psychoeducational, multiple-family program is a feasible and beneficial intervention for families of people with severe mental illness in impoverished post-war settings.

Authorship in Global Mental Health Research: Recommendations for Collaborative Approaches to Writing and Publishing

“…In Kosovo, a partnership was formed between Kosovar mental health clinicians and HIC clinicians and researchers who are experts in the field of family therapy. The Kosovar Family Professional Educational Collaborative (KFPEC) followed a model wherein authorship alternated between American and Kosovar contributors (7, 8). This division assured dyads of Kosovar-American contributors at each level, rather than having all LMIC contributors sandwiched somewhere between 4 th and second-to-last authorship.…”

Interventions for Children Affected by War

“…39 Families participated in seven sessions of psychoeducation about chronic mental illness—led by a local psychiatrist and nurse and supervised by trained local services teams and American study consultants. The therapy aimed to increase compliance with psychiatric medication among war-affected individuals in treatment and to improve mental health service use among families.…”

“…130 In Kosovo, even multiple-family groups were shown to be feasible, which has tremendous promise for future cost-effective interventions that may be made across the social ecology. 39 …”

Posttraumatic Psychological Distress and Resettlement: The Need for a Different Practice in Assisting Refugee Families

“…In what appears to be seminal research conducted in Bosnia and Kosovo (Griffiths et al, 2005;Landau, 2007;Walsh, 2007;Weine et al, 2004;Weine et al, 2005;Weine et al, 2008), there is promise of new treatment methods based on the family as a social unit and on the community as the support network. As Griffiths et al (2005) outlined, ''mental health interventions need to be community based in the aftermath of war trauma, genocide, and organized political violence'' (p. 556).…”

“…Various authors argue that there is an urgent need to criticize the dominant biomedical discourse and Western assessment and intervention tools such as posttraumatic stress indicators, talk therapies, and medication, because they do not take into account the interdependence of psychological processes and social environments (Neill, 2000;Weine et al, 2005;.…”