World Mental Health Day is observed annually on October 10. The theme of the World Health Organization’s 2026 campaign is “The Voice of Lived Experience: Real Voices, Real Change”. It draws attention to the meaningful engagement of people with lived experience in the mental health sector and to the recognition of their knowledge as a valuable form of expertise. When people with lived experience are meaningfully engaged, mental health systems become more person-centered, grounded in human rights, and better aligned with people’s needs and concerns.
Mental health is an integral part of public health and has a direct impact on quality of life, social inclusion, employability, and economic development. Globally, more than one billion people live with a mental disorder, with depressive and anxiety disorders being among the most common conditions. In Bulgaria, approximately 16.4% of the population lives with a mental disorder, corresponding to about one in every six people. Mental disorders are also the second leading cause of years lived with disability in the country.
In 2025, 39 676 hospitalisations for mental and behavioural disorders were recorded in Bulgaria, representing 617 hospitalisations per 100 000 people. Following a decline during the 2020–2021 period, a recovery and an increase in the use of inpatient psychiatric care have been observed.
There were 2733 alcohol-related hospitalisations, or 42.5 per 100 000 people. Compared to 2024, this represents a 4.4% decrease. However, the figure remains a key indicator of the need for effective measures regarding prevention, early intervention, and addiction treatment.
In 2025, 11 249 cases of acute intoxication with psychoactive substances were recorded. Of these, 8499 involved men and 2750 involved women. Alcohol was the leading substance cited, accounting for 7,38 cases, followed by narcotic substances and combined use. Among individuals under the age of 18, 1481 cases were recorded.
Suicide data show significant gender differences. In 2025, the mortality rate from intentional self-harm was 11.0 per 100 000 men and 3.2 per 100 000 women. The overall rate was 7.0 per 100 000 people, with the mortality rate among men being approximately 3.4 times higher.
Despite available resources, psychiatric care in Bulgaria remains predominantly hospital-oriented. Outpatient and community-based services are underdeveloped, and access to specialists remains uneven across the country’s regions.
Staffing is among the key challenges. For 2025, 16 state-funded residency positions in psychiatry were allocated, yet only two (or 12.5%) have been filled. By the end of the year, the number of psychiatrists had decreased by 1.1% compared to the previous year. These figures highlight the need for consistent measures to attract, train, and retain specialists.
Access to psychiatric care in Bulgaria remains among the lowest in the European Union. According to data from the Organisation for Economic Co-operation and Development, only 26% of people with mental disorders receive treatment, compared to an average of approximately 33% for the European countries included in the analysis.
The main barriers to seeking help are financial difficulties, fear of doctors or treatment, stigma, and distrust of the system. 46% of respondents cite financial constraints as the reason for not seeking necessary mental health care, 31% refrain due to fear of doctors or treatment, and over 80% believe that people with mental disorders are viewed negatively by society. 47% state that medical professionals treat patients with mental disorders differently.
Overcoming stigma is a shared responsibility of institutions, medical professionals, the media, the education system, and civil society. It is essential that mental health be viewed as part of overall health and that people with mental disorders receive timely, high-quality, and non-discriminatory care.
The Bulgarian Ministry of Health identifies the following as key priorities:
- Development of an integrated mental health system centered on individual needs.
- Transition from a predominantly institutional model to community-based services.
- Improving access to psychiatric and psychotherapeutic care.
- Reducing regional disparities in the provision of services and specialists.
- Ensuring a sustainable workforce for the system.
- Strengthening the prevention of suicide, self-harm, and addiction.
- Early detection and support for children and young people.
- Modernizing facilities and improving treatment conditions.
- Increasing mental health literacy and reducing stigma.
- Improving the collection, analysis, and use of mental health data.
Mental health reform must be a long-term national priority. Increasing funding is an important step, but sustainable improvement of the system requires the simultaneous development of human resources, modernisation of infrastructure, expansion of community-based services, and better coordination among health, social, educational, and other institutions.
The goal is to build a more accessible, integrated, and person-centered system that provides support as close as possible to where people live, learn, and work. The change must encompass not only treatment but also prevention, early intervention, rehabilitation, and social inclusion.
Mental health is a shared responsibility. Through sustained investment, qualified professionals, community-based services, and the reduction of stigma, Bulgaria can build a system that more effectively meets citizens’ needs and ensures equal access to quality care.