WHO and the United Nations Children’s Fund (UNICEF) have joined forces in North Macedonia to achieve significant improvement in young people’s mental health by 2030 and reduce suffering for those living with a mental health condition. As part of the joint programme, WHO launched a series of trainings for primary health care (PHC) workers and paediatricians to improve mental health services offered to young people at the PHC level across the country.

“As part of the UNICEF and WHO Joint Programme on Mental Health and Psychosocial Well-being and Development of Children and Adolescents, WHO in North Macedonia is supporting activities to strengthen the capacities of health-care workers in PHC to recognize, diagnose and support problems and conditions related to mental and psychosocial health in children and adolescents, implementing the WHO Mental Health Gap Action Programme (mhGAP),” explained Dr Stojan Bajraktarov, President of the National Mental Health Committee, and mentor of the joint programme.

The joint programme was launched in the WHO European Region on 5 May 2023 in 3 countries in the western Balkans – Albania, North Macedonia and Serbia.

The trainings rolled out as part of the wider initiative also include an introduction to WHO’s “mhGAP intervention guide for mental, neurological and substance use disorders in non-specialized health settings”, which offers practical guidance on a variety of topics from effective and respectful communication with children and adolescents suffering from mental and behavioural disorders to diagnostics and treatment planning.

“PHC doctors are often the first point of contact for children and their families when it comes to mental health concerns. It’s important that they have the skills and knowledge to provide timely and effective care,” emphasizes Dr Katarina Stavric from the Department of Family Medicine, Medical Faculty Skopje, one of the trainers of the training series.

PHC is the first point of contact with the national health system for many individuals, families and communities – it is the most accessible form of treatment and care. Additionally, as PHC services are not linked to any particular health condition, there is less fear of stigmatization, marginalization or discrimination by the community when people turn to PHC workers with their problems, which makes looking for help and treatment here more acceptable to many.

“The mhGAP module is an invaluable resource for us, PHC doctors, to upskill in mental health care. Asking for help on the PHC level, people are less worried about being judged by the community, which makes our support more acceptable and therefore more accessible to most service users and families,” adds Dr Svetlana Smugreska, a paediatrician and one of the training participants.

The first round of training was delivered to PHC professionals and paediatricians in the municipalities of Skopje and Tetovo. Here, 195 doctors are now equipped to start applying the guide in their daily practice for effective psychosocial interventions at the PHC level.

“The mhGAP module provides evidence-based guidance for PHC doctors to effectively identify and manage mental health problems in children and adolescents, and provide appropriate treatment and care,” says Dr Naser Durmishi, of Skopje’s University Clinic for Psychiatry, supporting the initiative as a trainer on mental health support.

The programme continues throughout 2023, aiming at training 600–700 general practitioners and paediatricians from various regions across the country.

WHO/Europe has been pursuing mental health system transformation in the western Balkans through the Pan-European Mental Health Coalition. In October 2022, a subregional meeting of the western Balkans was held in Tirana, Albania to explore partnerships and progress in the objectives of the Roadmap for Health and Well-being in the Western Balkans.