Andia Meksi1,2, Gentiana Qirjako1,2,3, Ilir Mica4, Brikena Allikoja4, Ada Velo4, Enilda Duro4, Iva Çajupi4, Elona Ceca4, Ermonela Dokle4, Ermela Shutina4, Ornela Ohrin4, Brilant Afmeti4
1Institute of Public Health, Tirana, Albania;
2Community Center for Health and Wellbeing, Tirana, Albania;
3Faculty of Medicine, University of Medicine, Tirana, Albania;
4Mental Health Community Center No. 1, Tirana, Albania.
Mental health is a major public health issue in Albania. During the last 20 years health reforms have been taken in order to improve mental health services and make them more reachableand effective for those in need. Inclusion of psychotherapeutic services in public mental health settings is a relatively new intervention. Most psychologists and social workers working in community based mental health services lack knowledge and skills to provide evidence based interventions. Also the existing mental health services lack the resources to accommodate and provide services for all the population in need. The poor infrastructure and limited number of inter-disciplinary health professionals in place creates work overload and decreases treatment efficiency. Considering these challenges, the Ministry of Health agreed to include one of the Community Based Mental Health Centers in Tirana (QKSHM, No. 1) in a pilot project called Implement All which aims to improve the implementation of e- mental health interventions by using an internet based platform called “I Fight Depression” for the treatment of patients with depression. The project started in 2017 with preparatory activities such as translation and adaptation of the platform in Albanian language, introduction of the intervention and treatment protocol to the mental health professionals, training of the psychologists on CBT and application of ICBT interventions. The platform became operational in June 2018. Since then more than 50 patients were given access to the platform by the therapist from the QKSHM 1 with the purpose of self-managing their depressive symptoms. Therapist also provide expertise and guidance to patients while using the platform. One of the major challenges related to the implementation of this new intervention have been the recent natural emergency events that slowed down the implementation process. Since then, the staff has been movingouttwice due to the lack of an appropriate housing conditions that would accommodate and make it possible for them to continue with the implementation of the intervention. Despite the fact that the staff had to deal with infrastructure problems such as: a dysfunctional electric system or lack of space to put on computers in order to deliver the intervention, the staff decided to continue with the implementation by using the face to face CBT intervention and also using the platform guidelines as an instrument for the treatment of patients with depression. This bold and professional decision was made based on the needs of the patients to continue the treatment and the staff’s intention, particularly the therapist’s aim to improve their treatment skills on CBT.
Keywords:community mental health center, ICBT intervention, treatment of depression.