Community Mental Health Journal

, Volume 48, Issue 3, pp 352–362 | Cite as

Community Mental Health Centres Initiated by the South-Eastern Europe Stability Pact: Evaluation in Seven Countries

  • Stefan PriebeEmail author
  • Aleksandra Matanov
  • Neli Demi
  • Joka Blagovcanin Simic
  • Sandra Jovanovic
  • Milena Gajic
  • Elizabeta Radonic
  • Stojan Bajraktarov
  • Larisa Boderscova
  • Monika Konatar
  • Raluca Nica
  • Matthijs Muijen
Original Paper


Eight community mental health care centres (initiated by the South-Eastern Europe Stability Pact) in Albania, Bosnia-Herzegovina, Croatia, Macedonia, Moldova, Montenegro and Romania were evaluated. Characteristics of patients, patient reported outcomes and patient views of care were assessed in 305 psychiatric patients. Patient characteristics varied across centres, with most patients having long term psychotic disorders. Treatment satisfaction and therapeutic relationships were rated favourably. Subjective quality of life mean scores were rather low, with higher satisfaction with health and dissatisfaction with the financial and employment situation. Being unemployed was the only factor associated with poor quality of life and lower treatment satisfaction. Most developing centres target patients with persistent psychotic disorders. Care appears highly valued by the patients. The findings encourage establishing more centres in the region and call for employment schemes for people with mental illnesses.


Mental health care evaluation South-Eastern Europe Quality of life Treatment satisfaction Therapeutic relationship 



The authors thank the managers and staff of the participating community mental health centres for their contribution to the study. We would also like to acknowledge the support of Ms Vesna Puratic and Ms Taida Kapetanovic from the SEE Mental Health Project Regional Office in Sarajevo, Bosnia and Herzegovina.

Conflict of interest



  1. Attkisson, C. C., & Zwick, R. (1982). The client satisfaction questionnaire: psychometric properties and correlations with services utilisation and psychotherapy outcome. Evaluation and Program Planning, 5, 233–237.PubMedCrossRefGoogle Scholar
  2. Beecham, J., & Knapp, M. (2006). Costing psychiatric interventions. In G. Thornicroft (Ed.), Measuring mental health needs, 2nd ed. (pp). London: Gaskell.Google Scholar
  3. Burns, T., Catty, J., Becker, T., Drake, R. E., Fioritti, A., Knapp, M., et al. (2007). The 4. effectiveness of supported employment for people with severe mental illness: A randomised controlled trial. Lancet, 370, 1146–1152.PubMedCrossRefGoogle Scholar
  4. Gibert, N., Richards, A., Barkham, M. & Coles-Gale, R. (2003). Primary care mental health worker service: Evaluation report. Retrieved September 7, 2009, from
  5. Hansson, L., Bjorkmann, T., & Priebe, S. (2007). Are important patient-rated outcomes in community mental health care explained by only one factor? Acta Psychiatrica Scandinavica, 116, 113–118.PubMedCrossRefGoogle Scholar
  6. Healthcare Commission. (2008). Survey of users of community mental health services. Retrieved from
  7. Jankovic Gavrilovic, J., Lecic Tosevski, D., Colovic, O., Dimic, S., Susic, V., Pejovic Milovancevic, M., et al. (2005). Association of postraumatic stress and quality of life in civilians after air attacks. Psihijatrija Danas, 37(2), 297–305.Google Scholar
  8. Johnson, S., Nolan, F., Pilling, S., Sandor, A., Hoult, J., McKenzie, N., et al. (2005). Randomised controlled trial of acute mental health care by a crises resolution team: The north Islington crisis study. British Medical Journal, 331, 559–603.CrossRefGoogle Scholar
  9. Kucukalic, A., Dzubur Kulenovic, A., Ceric, I., Jacobsson, L., Bravo-Mehmedbasic, A., & Priebe, S. (2005). Regional collaboration in reconstruction of mental health services in Bosnia and Herzegovina. Psychiatric Services, 56, 1455–1457.PubMedCrossRefGoogle Scholar
  10. Larsen, D. L., Attkinsson, C. C., Hargreaves, W. A., & Ngyen, T. D. (1979). Assessment of client/patient satisfaction: Development of a general scale. Evaluation and Program Planning, 2, 197–207.PubMedCrossRefGoogle Scholar
  11. McGuire–Snieckus, R., McCabe, R., Catty, R., Hansson, L., & Priebe, S. (2007). A new scale to assess the therapeutic relationship in community mental health care: STAR. Psychological Medicine, 37, 85–95.PubMedCrossRefGoogle Scholar
  12. Muijen, M. (2008). Focus on mental health care reforms in europe: mental health services in Europe: An overview. Psychiatric Services, 59, 479–482.PubMedCrossRefGoogle Scholar
  13. Priebe, S., Bogic, M., Ajdukovic, D., Franciskovic, T., Galeazzi, G. M., Kucukalic, A., et al. (2010a). Mental disorders following war in the Balkans: A study in 5 Countries. Archives of General Psychiatry, 67(5), 518–528.PubMedCrossRefGoogle Scholar
  14. Priebe, S., Hoffman, K., Isermann, M., & Kaiser, Wolfgang. (2002). Do long-term hospitalised patients benefit from discharge into the community? Social Psychiatry and Epidemiology, 37, 387–392.CrossRefGoogle Scholar
  15. Priebe, S., Huxley, P., Knight, S., & Evans, S. (1999). Application and results of the Manchester short assessment of quality of life (MANSA). International Journal of Social Psychiatry, 45, 7–12.PubMedCrossRefGoogle Scholar
  16. Priebe, S., Jankovic Gavrilovic, J., Matanov, A., Franciskovic, T., Knezevic, G., Ljubotina, D., et al. (2010b). Treatment outcomes and costs at specialized centers for the treatment of PTSD after the war in former Yugoslavia. Psychiatric Services, 61, 598–604.PubMedCrossRefGoogle Scholar
  17. Priebe, S., Matanov, A., Jankovic Gavrilovic, J., McCrone, P., Ljubotina, D., Knezevic, G., et al. (2009). Consequences of untreated posttraumatic stress disorder following war in former Yugoslavia: Morbidity, subjective quality of life, and care costs. Croatian Medical Journal, 50, 465–475.PubMedCrossRefGoogle Scholar
  18. Priebe, S., McCabe, R., Bullenkamp, J., Hansson, L., Lauber, C., Martinez-Leal, R., et al. (2007). Structured patient-clinician communication and 1-year outcome in community mental health care: Cluster randomised controlled trial. British Journal of Psychiatry, 191, 420–426.PubMedCrossRefGoogle Scholar
  19. Priebe, S., Reininghaus, U., McCabe, R., Burns, T., Eklund, M., Hansson, L., et al. (2010c). Factors influencing subjective quality of life in patients with schizophrenia and other disorders: A pooled analysis. Schizophrenia Research, 3, 55–62. doi: 10.1016/j/schres.2009.12.020.Google Scholar
  20. Priebe, S., Watzke, S., Hansson, L., & Burns, T. (2008). Objective social outcome index (SIX): a method to summarise objective indicators of social outcomes in mental health care. Acta Psychiatrica Scandinavica, 118, 57–63.PubMedCrossRefGoogle Scholar
  21. World Health Organisation (2008). Approaching Mental Health Care Reform Regionally: The mental health project for South-eastern Europe. Retrieved from

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Stefan Priebe
    • 1
    Email author
  • Aleksandra Matanov
    • 1
  • Neli Demi
    • 2
  • Joka Blagovcanin Simic
    • 3
  • Sandra Jovanovic
    • 4
  • Milena Gajic
    • 5
  • Elizabeta Radonic
    • 6
  • Stojan Bajraktarov
    • 7
  • Larisa Boderscova
    • 8
  • Monika Konatar
    • 9
  • Raluca Nica
    • 10
  • Matthijs Muijen
    • 11
  1. 1.Unit for Social and Community PsychiatryQueen Mary University of London, Newham Centre for Mental HealthLondonUK
  2. 2.WHO Country OfficeTiranaAlbania
  3. 3.University Clinic for Psychiatry, Clinical Centre Banja LukaBanja LukaBosnia and Herzegovina
  4. 4.Community Mental Health Centre MostarMostarBosnia and Herzegovina
  5. 5.Community Mental Health Centre PrnjavorPrnjavorBosnia and Herzegovina
  6. 6.Croatian Institute of Brain Research, School of MedicineUniversity of ZagrebZagrebCroatia
  7. 7.University Clinic of PsychiatrySkopjeMacedonia
  8. 8.NPO, Health Systems, FCHWHO Country OfficeChisinauRepublic of Moldova
  9. 9.Community Mental Health Centre KotorKotorMontenegro
  10. 10.Romanian League for Mental HealthBucharestRomania
  11. 11.WHO Regional Office for EuropeCopenhagenDenmark

Personalised recommendations