Suicidal Behaviour in Europe

Suicidal Behaviour in the Federal Republic of Yugoslavia (Serbia and Montenegro) (p. 177-178)

Description of the catchment area The city of Novi Sad is located in the north of Yugoslavia (and Serbia), spread out in the Pannonian plains on both sides of the river Danube. It lies about 100 km south of Hungary, 150 km west of Romania and about 40 km east of Croatia. It is the provincial capital of Vojvodina, Serbia’s northern province, populated by about 2 million people. It is also the economic, administrative and educational centre of the region. The population of Novi Sad itself is about 300,000. For more than 40 years Novi Sad has been a university centre, today comprising of nearly 20 various faculties with about 30,000 students. Novi Sad is the second largest city (next to Belgrade) of present Yugoslavia, not only in population, but also in the economic sense. Besides agriculture, which is one of the major areas of economiy, it is also a big industrial centre.

The health care system has, as in the whole country, undergone some very turbulent changes in recent years. A decade ago, in former Yugoslavia, it was entirely state managed, with no private practice possibilities and with health insurance that entitled full health coverage, which meant that everything (medication, inpatient and outpatient care) was free of charge for the individual. In the following years, with all the social upheavals and deteriorating economy, the health care system also changed significantly – for the worse. Private practices appeared and developed, while the public health deteriorated in quality, since the state lacked funds to support it. Fewer services were available through public health care, while private practices are not covered by health insurance of any kind, so the individual has to pay for them in full. The supply of medications in state owned hospitals and pharmacies has also decreased over the last decade, again for the same reasons, shortage of money. As the result, many privately owned pharmacies started up, offering a full range of medications (again, without the coverage of health insurance). Private pharmacies sell drugs without medical prescription and verbal requests for drugs, including all psychopharmaceuticals, are sufficient. This means, in practice, that even a teenager or a child can get sedatives or hypnotics just like any over-the-counter drug. Currently, the state is making an effort to eradicate this practice, but unless the overall situation of the state health care system and drug supply improves, this is not likely to happen.

In terms of outpatient health care, there are nearly 50 outpatient health centres in the municipality of Novi Sad. They offer services of general practitioners, as well as specialists in nearly all branches of medicine. Inpatient services are all grouped in a single Clinical Centre, with a capacity of about 1200 beds, consisting of various specialized units. The second inpatient facility is the Military Hospital, and contains almost a couple of hundred beds, mostly for patients with surgical and internal medical problems.