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Kosovo psychosocial needs assessment

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Here is the executive summary of a report prepared by a delegation that conducted a psychosocial needs assessment in Kosovo in September 1999. A list of the delegation's members follows the summary. To obtain a copy of the full 15-page report, send an e-mail message to Lorna Stevens of the International Rescue Committee. Her e-mail address is < lorna@intrescom.org >.
EXECUTIVE SUMMARY

This report summarizes the findings and recommendations of an 11-member, multi-disciplinary expert Psychosocial Needs Assessment Delegation to Kosovo organized by the International Rescue Committee. Integrating diverse outlooks that represent the best thinking in the field, the delegation visited Kosovo from September 8 to 13, 1999. The objectives were to assess the nature and quality of psychosocial and mental health services, define priority needs and identify service gaps, and make recommendations on the key issues.

Applying a broad conceptual framework that recognizes the interdependence of psychological and social factors on psychosocial well-being, the delegation's inquiry and analysis focused on the spectrum of prevention and assistance needs and services at four levels: society at large, local communities, families, and individuals.

New problems and new service configurations are emerging almost daily. Moreover, despite tragic losses, insecurity, massive dislocation, and extensive suffering and brutality -- all of which have led to disruption at all four levels of the framework=BE there is also evidence of resilience, with many returning Kosovars restoring their lives, villages, and towns.

Among the groups at highest risk are women who were raped or otherwise brutalized; people in underserved rural areas; the elderly and widows; people who witnessed mass murders and other atrocities; and minority groups such as Serbs and Roma. A significant number of adolescents have lost developmental opportunities at a critical time in their lives. There was evidence of some members of this group turning to substance abuse and violence. Rampant insecurity and anxiety about insufficient shelter for the upcoming winter are virtually universal.

The delegation identified issues in six areas requiring immediate attention:

  • approaches to psychosocial assistance;
  • reconciliation;
  • coordination and standards;
  • education, training, and capacity building;
  • planning and evaluating interventions,
  • and sustainability.
This report summarizes those issues and presents priority recommendations.

The contributions of the U.S. State Department Bureau of Population, Refugees, and Migration to psychosocial assistance in Kosovo are well recognized. These contributions have promoted psychosocial concerns across the board and established for the U.S. government a leadership position. To consolidate this position and improve the scope and quality of psychosocial assistance, the delegation recommends a number of additional initiatives that the U.S. government can undertake. In summary, these include:

Approaches to Psychosocial Assistance

Establish a task force, including experts from Eastern Europe to continue the assessment begun by this delegation and help further define priorities, guide program approaches and map and assess the efficacy of psychosocial services.
Reconciliation

Promote and support programs that emphasize dialogue among ethnic groups and tolerance building as a first step towards eventual reconciliation.
Coordination and Standards

Create culturally relevant standards for psychosocial assistance programs and develop new models of coordination for their implementation.

Education, Training and Capacity Building

Encourage and fund partnerships between universities and professionals in the region in the fields of psychiatry, psychology, social work, nursing, and teaching.

Planning and Evaluating Program

Establish sound criteria for funding psychosocial assistance and mandate monitoring and evaluation of programs.
Sustainability

Provide long-term resources to local institutions including training, technical assistance, and small grant support to Kosovar NGOs.

These actions are critical in meeting the psychosocial needs of Kosovo citizens and in coordinating an appropriate international response to the crisis. The lessons of Kosovo could easily be applied to other situations of war, forced migration and mass violence.

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Appendix A

KOSOVO PSYCHOSOCIAL NEEDS ASSESSMENT

DELEGATION MEMBERS

Neil Boothby, Ph.D., Director, Children in Crisis, Save the Children USA

Frederick Burkle, M.D., MPH, Director, Center of Excellence in Disaster Management and Humanitarian Assistance, CDC Honolulu; Executive Director, Health Unit, IRC

Mary Diaz, MA, Executive Director, Women's Commission for Refugee Women and Children

Matthew J. Friedman, M.D., Ph.D., Executive Director, National Center for Post-Traumatic Stress Disorder (PTSD)

Anica Mikus Kos, M.D., Head, WHO Collaborating Center for Child Mental Health, Ljubljana; Head, Center for Psychosocial Help to Refugees

Barbara Lopes Cardozo, M.D., MPH, International Emergency and Refugee Health Branch, CDC

Maryanne Loughry, MA, Pedro Arrupe Tutor, Refugee Studies Programme (RSP), University of Oxford

Salih Rasavac, BA, Program Manager, Corridor Psychological Therapy Program, Sarajevo

Marie de la Soudiere, MSW, Director, Children Affected by Armed Conflict Technical Unit, IRC

Captain John J. Tuskan, Jr., RN, MSN, Senior Public Health Advisor, Refugee Mental Health Program, Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, Department of Health and Human Services

Michael G. Wessells, Ph.D., Professor of Psychology, Randolph Macon College; Consultant, Christian Children's Fund