title: Management in child and adolescent psychiatry: how does it look in the Balkans?
abstract: This paper examines the situation of child and adolescent psychiatry in the following Balkan countries: Greece, Serbia, Bulgaria, Romania, Bosnia and Herzegovina, FYROM, and Montenegro. With the exception of Greece, these countries are new democracies, with their mental health services in a transitional stage of organization. Overall, they have initiated programmes to move psychiatric care towards deinstitutionalization, developing outpatient infrastructures to handle psychiatric disorders. Child psychiatry as a specialization is still less developed than adult psychiatry at a significant, albeit different degree among these countries. The number of mental health services offered to children and adolescents is deemed insufficient, and the type of services limited and lacking. This situation is also reflected in the small number of child psychiatrists and other mental health specialists for children and adolescents, as well as in the complete lack (Montenegro) or deficiency of special programmes and actions for children and adolescents. The same also applies to mental health legislation. Greece is the exception in the development of the entire spectrum of services, the number of specialists, and the establishment of an adequate legislation framework reinforced by the incorporation of all international treaties on children's rights; although the recent economic crisis has affected the country negatively, threatening with regression to pre-reformational practices. Children and adolescents in need of mental health care have been increasing in all countries. The effect of violent and sudden changes taking place in most countries is a major factor for the emergence of increased and stress-related psychopathology and psychosocial problems in children and families. In all countries, there is a significant development of nongovernmental organizations undertaking a large part of reformation work. There is also the disconcerting phenomenon of professional exhaustion and the migration of experts from their countries. Finally, there is the common need to develop educational programmes and related clinical practices in all degrees of prevention, promoting interdisciplinary cooperation, the biopsychosocial approach to understanding and dealing with mental health issues, as well as the development of cooperation among all institutions concerning children (education, health, etc.). All this should be reflected in a national plan to promote child mental health as the foundation upon which the necessary cooperation among Balkan countries would be established in order to promote research, the exchange of experiences, common practices, mutual understanding, and common interests.
authors.affiliation: School of medicine, University of Belgrade.
authors.forename: M
authors.initials: M
authors.lastname: Pejovic-Milovancevic
authors.affiliation: Association for Mental Health Promotion, Belgrade, Serbia.
authors.forename: V
authors.initials: V
authors.lastname: Miletic
authors.affiliation: Associate Professor of Child Psychiatry, University of Athens, Athens, Greece.
authors.forename: D
authors.initials: D
authors.lastname: Anagnostopoulos
authors.affiliation: University Clinic of Psychiatry, Skopje, Former Yugoslav Republic of Macedonia.
authors.forename: M
authors.initials: M
authors.lastname: Raleva
authors.affiliation: Faculty of Public Health and Sport South-West University "Neofit Rilski" Blagoevgrad, Bulgaria.
authors.forename: V
authors.initials: V
authors.lastname: Stancheva
authors.affiliation: Clinic for Psychiatry, Clinical Center of Banja Luka, Bosnia and Herzegovina.
authors.forename: M
authors.initials: M
authors.lastname: Burgic-Radmanovic
authors.affiliation: Medical Clinical Center of Montenegro, Psychiatric Clinic Podgorica, Montenegro.
authors.forename: Z
authors.initials: Z
authors.lastname: Barac-Otasevic
authors.affiliation: Faculty for Special Education and Rehabilitation, University of Belgrade, Serbia.
authors.forename: V
authors.initials: V
authors.lastname: Ispanovic
mesh_terms: D000293:Adolescent; D000296:Adolescent Psychiatry / Q000706:statistics & numerical data* / Q000639:trends; D063368:Balkan Peninsula; D002648:Child; D002665:Child Psychiatry / Q000706:statistics & numerical data* / Q000639:trends; D005260:Female; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data / Q000639:trends