Building primary care practitioners’ attitudes and confidence in mental health skills in post-conflict Bosnia and Herzegovina

Abstract

Our program attempted to integrate community mental health in primary care settings in post-conflict Travnik, Bosnia and Herzegovina. The training program underwent an extensive evaluation to determine its impact on the mental health knowledge, confidence in performing medical and psychiatric procedures, skills and attitudes of 93 Bosnian primary care practitioners (PCPs). There was a significant improvement in PCPs confidence in all clusters of medical and psychiatric procedures (counseling, prescribing psychotropic medications, treating trauma victims, diagnosing and assisting with social issues, stress reduction, future leadership skills/roles, utilizing the referral system and treating vulnerable populations) comparing baseline to post-training and baseline to two-year follow-up (p<.05). However, psychiatric diagnosis was not statistically significant comparing baseline to post-training (p=.055) or baseline to two-year follow-up (p=.052). This study supports the feasibility of training PCPs in a culturally effective manner in a post-conflict society such as Bosnia and Herzegovina.

Keywords:

• Bosnia
• primary care practitioners (PCPs)
• psychiatric symptoms
• depression
• confidence
• trauma

Acknowledgements

This project was funded by an unrestricted grant from the World Bank. We would like to acknowledge the great contribution of all the primary care physicians and psychiatrists who participated in this historic training in the Travnik, Bosnia and Herzegovina, as well as the local and Ministry of Health Federation of Bosnia- Herzegovina.