oT pic: The mental health system as a target of transitional justice: Mental Health reform in post-communist Albania situation. His decision made the court the only responsible institution for the removal of medical procedures. Furthermore: “…branches of Internal Affairs in districts, which had in their territory sick people towards whose court had decided medical proceedings, were obliged to control the application of these decisions and the conditions of patients. (They would be controlled by a policeman).” This secret directive had as an appendix the nominal list of 33 mentally ill people who had committed crimes and must be detained (their term instead of hospitalization) in psychiatric hospitals. A search in Kujto.al (English: Remember.al) an online platform for remembrance of victims of the communist regime, showed that 15% or 5 of the 33 individuals were political prisoners and enemies of the regime. Their punishment consisted of ten to twenty years in prison for betrayal to the state, while one of them was shot to death. 10.2 Failures of the Mental Health system and the right to health According to a report from the Ministry of Health in 1968, the total number of beds in psychiatric institutions was 900 or 1 bed per 2000 inhabitants. They had made a comparison with other states and had estimated that the ideal ratio was 3 beds per 1000 inhabitants. This ministry proposed the launch of two colonies (group of patients) in Vlora and Elbasan, with patients from those psychiatric hospitals. There the patients would benefit society by working in agriculture. In files from 1975 the situation of the mental health system in communist Albania was still chaotic and the needs of patients were not satisfied. Moreover, the Minister of Health in relation to the national situation of mentally ill people claimed that “in 1975 they had 1250 beds for mentally ill people, of which 330 were in Vlora, 820 in Elbasan and 100 in Tirana”, but there weren’t enough for citizens’ needs, which were estimated to be more than 2000 patients. In this document also mentioned are cases of compulsory treatment sent by judicial institutions, as a long-term treatment. Also, the feeble-minded (an old, offensive term used for mental deficiency), referring to children over 14 years, were sent to the Elbasan psychiatric hospital after their treatment in the ‘House of mentally handicapped children’. Most of them used the institution as a shelter because they were abandoned by their families. In a document from 1975 sent to the Prime Minister’s Office from the Minister of Health, Llambi Ziçishti, there was evidenced of the urgent need for hospitalization of more patients with compulsory treatment. The outpatient service treated during this year 2000 cases, that should have been be hospitalized, but due to the large number of patients from compulsory treatment, and so-called ‘feeble-minded’ patients from orphanages, there limited space. The minister Ziçishti requested from the justice institutions a specific filter to decisions about compulsory treatment, because of the incapability of actual mental health institutions to admit more cases. Nevertheless, Llambi Ziçishti closed his official letter towards the Prime Minister with the message that “there will always be place for aggressive patients in Albanian psychiatric institutions”. Through investigation of files in the General Directorate of Archives for the period 1966-1977, it is evident that the challenges that the Albanian mental health system was facing were persistent throughout the decade. An insufficient number of beds, limited medical staff, and lack of buildings were some of the indicators that continuously were reported as unable to be managed by the available resources. Consequently, whether not declared openly in official documents, the absence of these essential resources is paralleled by a lack of medicines, sanitation, and hygiene, optimal nutrition, qualified medical staff, etc. Even though the system of surveillance and monitoring was active, the perception of state officials of beneficiaries of the mental health system was related to stigmatization and resentment. In official documents, offensive concepts about the mentally ill were used. 111