Mental health services for war-affected children: report of a survey in Kosovo.
BACKGROUND
In war-affected societies it is assumed that the major mental health problem facing the population will be stress reactions.


OBJECTIVE
To describe the creation of a child and adolescent mental health service (CAMHS) in Kosovo after the military conflict ended in 1999, and to establish the range of problems and diagnoses that presented.


METHODS
Data were collected on 559 patients over 2 years, including their referring problems and diagnoses.


RESULTS
Stress-related disorders constituted only a fifth of the case-load in year 1. A substantial number of patients were symptom-free but attended because they had been exposed to a traumatic event, and believed it might make them ill. Non-organic enuresis and learning disability were the most common diagnoses in year 2. Many patients had a complex mix of social and psychological difficulties that did not fit conventional diagnostic categories.


CONCLUSIONS
Mental health services that only address traumatic stress may fail to meet the needs of war-affected children. A comprehensive, culturally appropriate CAMHS is needed to address a wide range of problems including learning disability. It should be developed through local actors, and build on existing local infrastructure. Services can also have an educational role in 'depathologising' normative responses.
Jones
Lynne
L
Child Advocacy International and Centre for Family Research, Cambridge University, UK.
Rrustemi
Alban
A
Shahini
Mimoza
M
Uka
Aferdita
A
D000293:Adolescent; D000328:Adult; D002648:Child; D002653:Child Behavior Disorders / Q000453:epidemiology; D002662:Child Health Services / Q000458:organization & administration*; D002675:Child, Preschool; D003469:Culture; D004775:Enuresis / Q000453:epidemiology; D005260:Female; D006801:Humans; D007223:Infant; D007859:Learning Disabilities / Q000453:epidemiology; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000523:psychology; D008605:Mental Health Services / Q000458:organization & administration*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D011593:Psychology, Social; D012017:Referral and Consultation; D013315:Stress, Psychological / Q000523:psychology; D014857:Warfare; D015022:Yugoslavia / Q000453:epidemiology