oT pic: The mental health system as a target of transitional justice: Mental Health reform in post-communist Albania METHODOLOGY This paper aims to evaluate the relationship between political transition and the mental health system, and how the system guarantees the rights of citizens in terms treatment, dignity and a right to health. It also addresses the application of punitive psychiatry in Albania during the communist regime, using the mental health system as a form of repression against political dissidents, and the role transitional justice has in addressing this. This is study uses both primary data collected in semi-structured interviews and secondary data from archives. The semi-structured interviews are conducted with eleven people, who are chosen for their insight and understanding of the mental health system and its post-transition reform. Four of the interviewees are linked to punitive psychiatry: one is a victim of punitive psychiatry and three have testimonials about cases of punitive psychiatry. Two of the interviewees are former medical staff in psychiatric hospitals during the communist regime, three are representatives of civil society such as associations, research institutes, and centers for trauma and rehabilitation of traumatized people and/or victims. Two interviews are conducted with contributors to the first law for mental health in Albania in 1996 and the project for deinstitutionalization of mental health services in favor of a community approach. The secondary data is based on archival research, in the General Directorate of Archives. The source of information is the Ministry of Health’s administrative data during the communist regime (fund number 512), while the reviewed documents cover the period 1966-1977. The keywords used during the archival investigation were psychiatry, mental illness and periodic health report(s). This study respects the confidentiality of individuals involved in the mental health system and maintains the anonymity of all victims, patients and contributors to this research, except where they have been in strategic leadership positions such as minister, attorney general or have been already exposed to the public. For all the interviews informed consent has been given. Interviewees are introduced to the research aim and the way that their interview will be analyzed. All were adults and considered mentally competent to decide about their willingness to participate in this research. The challenges of this research occurred especially in the data collection process, because of the limited amount of information. Punitive psychiatry is a rarely referenced concept in Albania and there are no previous specific researches conducted on this topic, although, there are some attempts in the form of an Encyclopedic dictionary for the victims of the communist regime and some articles for daily journals. Moreover, the category of victims of punitive psychiatry in Albania is smaller, in comparison to former political prisoners and this makes it difficult to trace and interview them. The analysis process has taken into consideration the information provided by both archives and interviews. The selected information consists in significant documents, such as correspondence between institutions, reports, guidelines, court decisions, laws, etc. In addition, the literature review is focused on similar studies and research conducted in former communist countries. As the Albanian health system during the communist regime has adapted the Soviet Semashko health system and Albania-Russia diplomatic relations were active from 1948 until 1960, references to the former Soviet Union are relevant for this research. For instance, the former Soviet Union has evidenced cases of punitive psychiatry application against dissidents and ‘invented’ the term sluggish schizophrenia to justify the isolation of political enemies in psychiatry institutions. 105

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