A family-based mental health program of recovery from state terror in Kosova.

Family processes of communication, mutual support, and sustenance of cultural values can play vital roles in recovery from psychological and material damage in societies afflicted by terror. This is particularly the case when a campaign of terror has specifically targeted family life and its traditions, when the culture is one whose identity has been centered in its families, and when public mental health resources have been scarce. At the end of the 1999 war in Kosova, the Kosovar Family Professional Educational Collaborative (KFPEC) was initiated to counter mental health sequelae of war in Kosova. This initiative focused upon the recovery and strengthening of Kosovar families, rather than the psychiatric treatment of individuals for post-traumatic symptoms. Findings and outcomes from this project may usefully inform the design of other international public mental health initiatives.

A family approach to severe mental illness in post-war Kosovo.

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.