108 oT pic: The mental health system as a target of transitional justice: Mental Health reform in post-communist Albania guidelines and also correspondence between institutions such as the Ministry of Health and Ministry of Intern Affairs indicated a large number of mentally ill people, which was increasing every year. The mental health system in Albania was centralized exclusively in and managed only by psychiatric hospitals, which were located in Tirana, Elbasan, Durrës, and Vlora, with no outpatient facilities at all. All patients, despite their place of residence, were gathered in these hospitals for treatment, which implied isolation and sedative drugs. Referring to national morbidity statistics from 1967 and 1968 from four psychiatric hospitals, schizophrenia was the leading mental health disorder in both years, followed by other disorders which for unspecified reasons are not mentioned in this report. Tirana and Elbasan psychiatric hospitals reported largest burden of disease. INSUFFICIENT RESOURCES OF STATE TO MANAGE THE SITUATION Although the dictatorial state tried to manage all the developments in citizens’ life, due to insufficient resources health due to its high cost and especially mental health, which is usually a chronic condition, was a challenge for the regime. In a secret correspondence between the Ministry of Health and the Attorney General, Lefter Gega, on 4th March 1967, he expressed his concern about the rising number of mentally ill people who were released from psychiatric hospitals and because of their unstable mental condition, they were a danger for the safety and life of other citizens. Minister Gega pointed to the Ministry of Health as responsible for this bad management of the situation: “In practice, medical institutions have had a lack of performance in the direction of discharging patients from these psychiatric hospitals, without their being completely recovered. These medical institutions responded that ‘there are no available places’ to the request of district hospitals for admission of other patients. Consequently, these patients remain outside and they have committed crimes.” He requested from all the local institutions the application of compulsory treatment for these cases to prevent the increase of criminality. Simultaneously, with the request of the Prime Minister, on 31st March 1967, a secret correspondence occurred between the Minister of Internal Affairs, Kadri Hazbiu and the Ministry of Health about mentally ill people who represented a social threat. Mr. Hazbiu was referred to mentally ill people in this letter as people with a mental handicap, a denigrating term used in Albanian ‘e metë’ (essentially, ‘idiot’), an offensive term for those with a disability: “From a partial verification that this ministry (Ministry of Internal Affairs), it results that in many districts of the country, there are a considered number of people with a psychical handicap, main people with schizophrenia. Some of these sick people, after being treated in psychiatric hospitals are released as treated or improved and now they are free (in 5 districts, there 99 cases).”