oT pic: The mental health system as a target of transitional justice: Mental Health reform in post-communist Albania The Albanian Supreme State Audit Institution ends its report: “The legal provisions have been fragmented and inadequate, insufficient and have also lack of financial resources. Albanian society has opportunities for material reparation and reasonable rehabilitation of this social group at an optimal time, responding thus the legal obligations and those laid down in the International Conventions, which has taken over the establishment of the rule of law, to end this social scourge in our country.” The first time that punitive psychiatry during the communist regime was mentioned in media, was in a public declaration from the prime minister of that period, Mr. Sali Berisha. He emphasized the importance of inclusion in the compensation plan of the victims of punitive psychiatry, people who were isolated in psychiatry because of their political views. According to him, the psychiatric hospitals during the communist regime were used also as prisons for political enemies of the regime. Since the arrival of democracy, 300-310 victims of punitive psychiatry have benefited from the facilities and compensations foreseen in the reparation laws. This represents the victims who were sent to psychiatric institutions by court decision and have the necessary documents to prove their persecution. They were placed in the first category for compensation, together with former prisoners. According to the reparation law, they will benefit 2000 ALL (around 18$)/day of isolation in psychiatry. Although the monetary compensation is the most acknowledged form of reparation in Albania, the process of compensation is still ongoing. This has caused offense and displeasure to victims and their families, who have often organized strikes and protests. Recently, the victims of punitive psychiatry in Albania are facing challenges regarding acknowledgment. Even though the official number of victims of punitive psychiatry is 300-310, there are predicted to be more cases that were isolated in psychiatric institutions without a court decision. They are facing difficulty in proving persecution and they are excluded from the status of victim and also from compensation. To conclude, in Albania the concept of ‘punitive psychiatry’ isn’t well known by the population. This phenomenon is caused by several factors such as the small number of cases, lack of lobbying from institutions and non-governmental organizations, lack of research about health issues during communism and a consequent lack of media coverage. It is crucial for the history of Albania during the communist regime to define those who suffer, based on their documented history of persecution. Furthermore, recognition of all the victims of punitive psychiatry is a necessity. Presentation to the public with this concept and its application during the dictatorship is a form of assurance that lessons from the past, will serve for a safe future. To change the situation and to develop a bulwark against the misuse of the psychiatric profession in the future, it is pivotal that serious efforts are made in the provision of modern mental health literature in local languages, in education, and the monitoring of human rights in closed institutions. It is time that national and international psychiatric bodies resume their interest in these cases, exert pressure on the authorities in the countries concerned and support victims of political abuse of psychiatry in every possible way, e.g. by facilitating independent psychiatric evaluations of the persons concerned.27 In Albania, the first law of mental health was established in 1996. The main issues addressed were access to mental health care including access to the least restrictive care, rights of consumers and family members, competency, capacity, and guardianship issues for people with mental illness, 27. Victor Davidoff, Madeline Roache, Robert van Roren, Psychiatry as a tool of coercion in post-soviet countries 2012-2017, (Federation Global Initiative on Psychiatry, 2017). 115