Psychosocial support programs for refugee, returnee and displaced women: During the war and the immediate post-war period (from 1992 to 2000) the prevailing type of assistance was humanitarian and material aid (housing, food, clothes, shoes, furniture, stoves, firewood, medicines, medical interventions) provided to displaced persons and refugees, in particular those accommodated in collective centres.
The period after 2000 saw the implementation of sustainable return projects (house reconstruction and economic self-sufficiency). Initiators of psychosocial support programs were the UN and international organizations. Projects of support for displaced, refugee and returnee women (DRR) were implemented by local NGOs with the support of international organizations (economic, political and psychological women empowerment projects). Immediately after the war a number of NGOs implemented projects that targeted women who were victims of violence (inhuman treatment in concentration camps, rape, physical and psychological abuse). This type of psychosocial support diminished once the women who were victims of torture founded their own associations. When this took place, the NGOs involved in the abovementioned programs redirected their attention to providing psychosocial support to women victims of domestic violence. In recent years there has been a re-emergence of support projects targeting women victims of war torture. Trainings are being organized for expert staff members of mental health centres (MHC), social welfare centres (SWC) and NGOs in order to enhance the psychosocial support they provide to women victims of violence.
The formal legal framework for the provision of psychosocial support: Social and health protection is governed by legislation on several government levels, including the state level, the level of the two entities and Brčko District (BD) and the cantonal level (ten cantons in the entity of the Federation of Bosnia and Herzegovina). Such a complex administrative system results in an inconsistent approach.
The greatest drawbacks concern the lack of evaluation and control: a chronic lack of funds; poor expertise; lack of training programs for professionals working with DRR persons; lack of supervision of experts providing psychosocial assistance; slow and complicated administrative procedures; MHCs and CWSs not keeping separate registers of DRR persons nor conducting assessments of their psychosocial needs, as well as lacking specialized support programs targeting women; rigid implementation of existing legislation and the entrenched notion that solving the problems of a particular group of beneficiaries is in itself a form of discrimination; a bureaucratic system hindering imaginative solutions, leaving no room for a client-oriented approach, activism and self-initiative.
Among the greatest advantages are the following: a system of coordinated care for mental health is being developed on the municipal level (MHCs, SWCs, municipal administrative bodies); memoranda on cooperation have been signed in some municipalities; ministries of health are organizing trainings in mental health; domestic NGOs, in cooperation with international organizations, are training professionals in how to deal with women victims of torture.
The make-up of the DRR population: people who were in their “prime” when they migrated; women who lost male family members, and youth who were children during the war.
The DRR population faces the following problems: poor results in school and behavioural disorders among youth – indication of transgenerational trauma transfer; permanent exposure to stressful situations (housing, unemployment, poverty) - trauma accumulation; temporary resettlement due to flooding – re-traumatization; most frequent psychological problems –anxiety, neurosis, depression, PTSD.
Future prospects, suggestions and recommendations: institutional transformation – incorporating the protection of the DRR population into the social protection system, since the remaining DRR persons face commonplace social problems (housing, employment, poverty); enabling social welfare centres to provide psychological counselling services as well as providing additional training in psychotherapeutic work for their staff; conducting research on transgenerational trauma transfer; implementing psychosocial support programs for elderly women without relatives; opening day care centres for elderly persons, youth with behavioural disorders and persons with intellectual disabilities, where DRR women can get the specific treatment they need; developing projects on psychosocial treatment of women victims of torture; signing protocols on coordinated mental health care on the municipal level; strengthening the capacities of local communities; employing expert staff and providing continuous training (to social workers, psychologists, psychiatrists, neuropsychiatrists); ensuring supervision of professionals who work on mental health issues; strengthening NGOs that work with DRR women; raising awareness on the needs and problems of DRR women through media coverage, affirmation of good practices, establishment of women’s support groups.