The C-SSRS in Kosovo`s National Health Strategy for Suicide

The C-SSRS in Kosovo’s National Health Strategy for Suicide Prevention
As shared by Dr. Bashkim Kadriu
“I had the immense pleasure to meet Dr. Kelly Posner after a lecture she gave at Albert Einstein College of Medicine at
Bronx-Lebanon Hospital on suicide prevention. As a Psychiatric resident and somebody who had lived and experienced
personally tremendous ravages of the war in 1999, and recent increase in suicide rate in Kosovo, I met with Dr. Posner
and with her immense support we initiated the idea of adapting and translating C-SSRS. Fortunately, this effort was
presented to the Minister of Health of Republic of Kosovo, Dr. Agani who in collaboration with the Department of
Psychology at the University of Prishtina and the Ministry of Health of the Republic of Kosovo, have initiated the
adaptation and incorporation of the C-SSRS in the national health strategy for suicide prevention, which country of
Kosovo was implementing for the first time.
In the mind and eyes of people of Kosovo, the war of 1999 and atrocities and crimes committed there are still fresh.
However, the past traumatic experience from ravages of the war, exhaustion and despair and the present social
stressors have tremendously contributed in the remarkable increase in suicide behavior and suicide completion. A study
report published in the Torture 2009 by Wetzel et al., 2009 shows that in a representative country-wide survey
(n=1161), using subscales for suicidal behavior in the General Health Questionnaire (GHQ), comparing results with the
corresponding Hopkins Symptom Checklist (HSCL-25) items and the Harvard Trauma Questionnaire (HTQ) to assess war
related experiences and PTSD symptomatology. Irrespective of age, gender or education, subjects in rural areas had
higher suicide ideation scores, 41.7% of respondents met criteria for moderate to severe depressive symptomatology,
41.6% for clinical anxiety. Unemployment (83.7%), and high PTSD scores were associated with suicidal ideation scores,
the last contingent on depressive mood. The study concludes that suicidal ideation in Kosovo is linked to both past
stressful experience and present social stressors is a question to be considered in mental health care plans in postconflict zones. Under-recognition could be expected to result in increasing suicidal behavior.
As the process of implementation of C-SSRS is ongoing and it will probably take time to reach success, in my own believe
and in the eyes of many of Kosovars this represents an immense stepping stone into the prevention of suicide and an
immense contribution to the mental health of the population there.”