The world health organization reactivates mental health initiatives in North Macedonia

Mental health experts from all over North Macedonia explored ways to strengthen the country's community mental health scheme during a two-day workshop led by the WHO Country Office in North Macedonia and backed by USAID. Participants concentrated on creating work guidelines for community-based mental health care centers as well as an action plan for achieving better integration at the primary care level.

"The burden of mental disorders is already intense, and it is projected to rise significantly as a result of the COVID-19 pandemic and its socioeconomic implications," said Dr. Anne Johansen, WHO's Special Representative to North Macedonia. "The necessity to increase public mental health care is more apparent than before, particularly in the aftermath of the pandemic." As a key to rehabilitation from the COVID-19 emergency, we intend to place mental health and well-being at the center of the national health system."

The satisfaction of good mental health is a fundamental component of any individual's health and well-being, but it is far from guaranteed. Despite significant progress in North Macedonia, the COVD-19 pandemic has stretched healthcare systems in unimaginable ways, including by interrupting vital mental health support.

Making way for high-quality mental health care

The community mental health system in North Macedonia is primarily made up of mental health centers, which were established mainly due to reforms initiated and executed by WHO and the Ministry of Health between 2000 and 2008. The reform operation was halted between 2008 and 2017 due to a decrease in support for community mental health services and a bolstering of the hospital-focused mental health system until the adoption of a new National Strategy for the Promotion of Mental Health in the Republic of North Macedonia (2018–2025). The Strategy, which was embraced by the Government of North Macedonia in 2017, listed the main priority areas:

• mental health care decentralization
• decreasing the amount of psychiatric hospitals 
• strengthening medical staff at community mental health centers 
• developing a sustainable financial system for community mental health 
• creating a standard observing and evaluation system
• Continuing the reform process

"It is essential to ensure continuous training of personnel at mental health centers and solidify their work all through the country in order to further advance the community mental health system," says Dr. Stojan Bajraktarov, Director of the Psychiatry Clinic in Skopje and WHO mental health focal point.

"At the same period, continuous teaching of primary health care professionals is required to enhance mental illness understanding, de-stigmatize mental illness, and enlighten people with mental illnesses and their families. While there is a good referral program for both tertiary, secondary, and primary health care, the absence of continual coordination and interaction can totally hamper the efficacy of mental health care supplied at the primary health care level," Dr. Bajraktarov adds.

WHO will continue to assist health officials in restarting the reformation and creating comprehensive, consolidated, and adaptable mental health and social care services conveyed through local platforms. This seminar was the first step toward putting that plan into action.