The Bulgarian government approved an emergency €20 million package to address chronic underfunding in its state psychiatric hospitals, according to Euractiv.
The funding will raise staff salaries by 30% and renovate ageing facilities using EU recovery funds.
Bulgaria’s psychiatric care system, described by critics as “outdated and understaffed,” has faced repeated condemnation from international bodies like the Council of Europe. Reports highlight decaying infrastructure, reliance on physical restraints due to staffing shortages, and treatment methods unchanged since the communist era. The COVID-19 pandemic worsened conditions, with hospitals operating at 150% capacity and staff often working 12-hour shifts alone.
A recent case underscoring the crisis involved Boris, a young man who died by suicide after his family failed to secure a psychiatric bed in Sofia. His mother, Donka Yordanova, told Bulgarian National Television:
He was crying, telling me he needed help, that he was nervous and wanted to be admitted somewhere—even asking me to call the emergency services.
With 80% of psychiatrists aged over 55 and nurses as old as 81 in some facilities, the sector faces a looming workforce collapse.
While the funding boost aims to attract staff through higher wages—raising psychiatrists’ salaries to €1,550 monthly and nurses’ to €1,000—experts argue this fails to address perverse incentives embedded in the system. Hospitals receive €40 per patient daily, tied to bed occupancy rather than care quality, encouraging overcrowding over effective treatment.
Dr. Tony Donchev, a former psychiatric clinic director, criticised the approach as “firefighting”.
The question is not only about money. Even if we raise salaries, will the quality of care improve? I don’t think so. Doctors are already doing their best. The system itself needs to change.
Donchev and other advocates demand a complete restructuring of psychiatric care, including replacing bed-based funding, introducing oversight mechanisms, and decentralising management.
The government’s reliance on EU funds for renovations has also drawn scepticism. Critics argue that without systemic reform, upgraded facilities will merely “house the same broken model.”
