7.5 Mental health
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National strategy(ies)
The Croatian Government has adopted the Strategic Framework for Mental Health until 2030. The document recognises mental health as a public health priority and stresses the importance of implementing comprehensive and targeted measures for health promotion, prevention, protection of mental health, and treatment of mental disorders. The purpose of the Strategic Framework is to define, in alignment with other strategic documents, long-term goals for enhancing mental health protection. The aim is to reduce the occurrence of mental health disorders and related disabilities while increasing the accessibility of mental health services. The primary areas for developing quality mental health care include raising awareness about mental health problems, timely detection and diagnosis, and appropriate treatment and rehabilitation.
The specific objectives of the Strategic Framework are as follows:
- Preservation and improvement of mental health
- Prevention and early recognition of mental health problems
- Increasing the availability of effective psychobiosocial interventions while respecting human rights
- Community mental health care
Mental health protection is addressed at the levels of primary, secondary, and tertiary health protection, as mandated by the legal framework, including the Health Care Act and the Mandatory Health Insurance Act. Health protection is implemented by the Croatian Institute of Public Health (CIPH), county public health institutes, and health institutions.
The network of public health services also includes teams in charge of mental health protection, prevention, and outpatient addiction treatment in public health institutes at the county level. The existing addiction prevention services have expanded their activities to include mental health protection. As a result, the activities related to mental health protection, prevention, and outpatient addiction treatment have been organised at the county institute level. The CIPH has been assigned a strategic and coordination role, within the Division for School Medicine, Mental Health and Addiction Prevention, and more specifically the Department for Mental Health and Addiction Prevention.
The new National Youth Programme 2023-2025 highlights the mental health of young people as one of the priority areas within the 6th area, Health and the Crisis Caused by the Coronavirus Pandemic. Three measures are proposed:
- Protection and improvement of youth health during and after the pandemic:
Conducting research and collecting data are key to managing risks and addressing the impact of various factors on youth health
- Improving mental health literacy for all relevant stakeholders working with young people:
To implement this measure, a programme will be developed and implemented, providing youth workers with a set of knowledge and skills that facilitate the recognition of youth mental health problems (PoMoZi Da programme)
- Prevention of obesity and promotion of healthy lifestyles
Specific measures from the Action Plan for Obesity Prevention 2023-2026 target young people. These measures include educating young people in educational institutions, monitoring the nutrition and lifestyle habits of young people, as well as providing support in the treatment of young people with obesity
Several studies were conducted on the mental health of young people affected by the coronavirus pandemic. These studies examined the needs and challenges faced by high school students, graduate students, and university students. The 2020 project How Are We? Life in Croatia in the Age of Corona presents results obtained from a sample of 3,500 people who are 18 years old or older. The section pertaining to university students shows a concerning picture of the impact on the mental health of young people. A third of the students believe they will need psychological help. Additionally, 30% express mild depression, 23% report very or extremely pronounced depression, 17% of students express extreme agitation and anxiety, and 20% experience very intense stress. Notably, 10% of young people have severely impaired mental health, with students who are more concerned about their studies being particularly affected.
The results of a survey conducted among first and second-grade high school students reveal the impact of the pandemic on their lives. A significant portion of participants – 59.1% of high school graduates, 46% of students in other grades of high schools, and 37.6% of students in the eighth grade of elementary schools – marked this impact as extremely negative or negative. Eighth graders felt the greatest negative impact on engaging in extracurricular activities and hobbies, engaging in physical activities and sports, and on their mental health. Graduates identified mental health, engaging in extracurricular activities and hobbies, and engaging in physical activities and sports as the areas that suffered the most under the influence of the pandemic. When asked about the consequences on mental health, 77.4% of them noticed more or significantly more symptoms of depression, 87% observed anxiety states, (75.8% reported phobias and fears, and 58.5% experienced instances of peer violence in the virtual environment.
Improving the mental health of young people
Croatia does not have specific public policies targeting young people in the field of mental health improvement. However, certain measures within the already mentioned public policies are being implemented in Croatia on regional and local levels. These include the activities of the public health institutes network and the activities of numerous civil society associations aimed at young people. The UNICEF office in Croatia has launched a website intended for children and young people to support their mental health. Parents and educational staff can also find useful information on the website.