oT pic: The mental health system as a target of transitional justice: Mental Health reform in post-communist Albania The quality of treatment was improved due to the qualification and training of staff, including the scientific description of the mentally ill, based on scientific criteria. In 1940, the Italian-Greek war saw the relocation of Vlora Psychiatric Hospital to Shkodra, where patients were placed in a building that lacked the necessary facilities. Around 84 patients were sent to Voltera hospital, near Florence in Italy, but most of them were murdered by the Nazis. During the communist regime, patients who managed to survive Nazi executions were deported to Albania, at the special request of the Albanian state. During the communist regime, the state sought to control every aspect of a citizen’s life, through an unlimited power it addressed to itself. Health was one of the main objectives for the development of the Albanian communist state. It was centralized, which means that the state, through the decisions of the Ministry of Health, controlled and decided for every aspect and procedure in the health sector. Each hospital had to report everything to the Ministry of Health and indicators measured the performance of medical staff and hospitals. The Faculty of Medicine was founded in 1952 and this was the first opportunity to address the insufficient number of medical staff, especially physicians, in Albanian hospitals. In 1956, in Tirana, the capital of Albania, a psychiatry clinic was established with a capacity of 100 beds, which became a specialized center for the entire country. In 1964, the organized service of forensic psychiatry was also added to Tirana’s clinic of psychiatry, to treat patients who had committed crimes. On 29th November 1963, in Elbasan a psychiatric hospital was opened with 320 beds, expanded to 500 beds after the closure of the Durrës’ Psychiatric hospital. Expansion of a psychiatric colony with 300 beds nearby made Elbasan Psychiatric hospital the largest psychiatric center in Albania. In 1978, in Tirana a new neuropsychiatric hospital was opened with 200 beds, 100 of which were dedicated to the psychiatric clinic. In 1980 in this hospital the department of psychiatry for children was launched, the first center for treatment, screening, and prevention of psychiatric disorders in children. During the communist regime, the development of mental health policy in Albania was highly influenced by political ideology. Albania practiced the principles of the Soviet healthcare system, the so-called Semashko, which promised universal, free access to health services, including mental health services. The Ministry of Health was the regulatory and responsible institution for every initiative related to health, because Semashko health, a system state-run healthcare model, was centralized, integrated, and hierarchically organized with the government providing statefunded healthcare to all citizens. Albania, similar to all communist states, started to isolate itself from the science, and also the medical research, of the international scientific community. Before the communist regime and especially during the Kingdom of Ahmet Zog I, 1928-1939, scholarships were provided to doctors and medical students to European countries, such as Austria and France, to return to Albania and provide qualified medical help to citizens. The communist regime interrupted relations with West and other international agencies and the only alternative in the medical sciences was support from the Soviet Union. During the communist regime in Albania there were consistent violations of human rights: persistent terror, persecutions and executions together with propaganda, isolation, the prohibition of freedom of speech and unfavorable living conditions created an environment that allowed for the blossoming of mental health disorders. Several documents from the General Directorate of Archives, reviewed from the period 1966 to 1977, in terms of reports from psychiatric hospitals, 107