116 oT pic: The mental health system as a target of transitional justice: Mental Health reform in post-communist Albania voluntary and involuntary treatment and mechanisms to oversee involuntary admission and treatment practices, law enforcement and other judicial system issues for people with mental illness. However, the implementation of the Mental Health legislation is incomplete, due to the inappropriate infrastructure (health, social and legal) that should further foster the protection of the rights of the mentally ill and enhance their social inclusion. The implementation of the first law was a challenge because it required both human and financial resources towards a human rights approach. For the first time, a multidisciplinary team was initiated, beside the psychiatrist and nurse. Psychologists, social workers, and family doctors were part of the mental health system, which went from hospitalization towards deinstitutionalization. This meant a community-based treatment and rehabilitation of patients, where family and community members would play an active role and support them. At the early stages of this model’s application, community and families weren’t prepared to manage this responsibility, due to lack of education and also stigmatization, related to mental health disorders. From the year 2000, in Albania, the impact of international organizations such as the World Health Organization and also national actors have affected the development of the mental health system. Decentralization and deinstitutionalization are policies that project the progress of community care. Community care means offering therapeutic relations, rather than isolated therapeutic actions. Community care is continuity and responsibility in the care provided near the living environment, use of resources that offers community, inclusive orientation: multidisciplinary, participatory and coordinated.28 Currently, mental health problems in Albania are treated in a specialized way in 13 Supported Homes, 10 Mental Health Community Centers, 4 specialized mental health services with beds and 2-day centers. Education and fighting the stigmatization are efforts to provide acceptance in society of mental health issues. Mental health is not merely a health or medical concern, it is very much a matter of human rights, dignity, and social justice. Users of mental health services, persons with mental health conditions and persons with psychosocial disabilities are positioned at the confluence of many vulnerabilities, particularly those arising from poverty, stigma, discrimination, social isolation and segregation. In the post-communist Albania, mental health system addresses two approaches towards an inclusive health care: 1. The first approach is towards the rehabilitation of victims of the communist regime. These people have experienced mental health trauma, violence and abuse in the communist regime. They deserve acknowledgment, treatment with dignity and should benefit from preventive, curative and palliative health services. 2. The second approach is the addressing the human rights situation of mentally ill people, which requires the protection of their autonomy and dignity as well as the other human rights guaranteed by national laws, international legislative bills, and conventions. The United Nations claim that States have the primary obligation to protect and promote human rights. The right to health is relevant to all States: every State has ratified at least one international human rights treaty recognizing the right to health. Albania has undergone through a harsh dictatorial regime and transition process. This increases responsibility of State towards the right of health, as a national obligation to ensure an accessible health care for its citizens, but also protection of their dignity and freedom, as a contribution from the past legacy and accountability. 28. Ministry of Health (Albania), Political document and plan of development action of health services mental in Albania,(Shteti Web, 2003).