Mental health services in Moldova transformed by MENSANA project: Results of 12 years of reform

The Moldovan–Swiss project MENSANA – Support for the reform of mental health services in Moldova – has concluded its activities after 12 years of implementation, a period during which it contributed to the modernization and expansion of community-based mental health services in the Republic of Moldova.

The results of the reform were presented at the conference “12 Years of Reform and Development of Mental Health Services in Moldova”, held in Chisinau, which brought together representatives of public authorities, international partners, specialists from the health, education and social protection sectors, as well as service beneficiaries. 

Minister of Health Emil Ceban emphasized that the project had a major impact on the way the mental health system in the Republic of Moldova is organized and perceived.

“This day is very important for all of us, including those who contributed to this project, those who led it and all who participated in its different stages of implementation. I myself took part in various stages of this project, in different capacities, and today I represent it as minister. It is a very important project, and what we are discussing today and what has been achieved is of great value for the health system of the Republic of Moldova and, first and foremost, for patients. This project has fundamentally changed the concept and vision of mental health in the Republic of Moldova, transforming a predominantly hospital-based system, inherited from the Soviet period, into a system oriented toward community services and patient-centered care. Most importantly, the approach to the patient has changed. If previously the patient was only a passive beneficiary of services, today they become part of the decision-making process, and together with the medical team decisions are made regarding treatment and the necessary support. This project has given us the opportunity to look differently at people and their needs. We have managed to develop a better organized structure in which each district center has functional mental health services. In recent years, we have seen directly in the field how these centers operate and how the reform has changed the quality of medical services. It is a system that has been strengthened both technically and legislatively, being integrated into primary health care. In the future, it is essential to further develop the interdisciplinary character of these services, by involving psychologists, social workers and other specialists, as well as by placing emphasis on the mental health of children and adolescents. We are also working on integrating mental health and addiction services into family medicine so that patients can receive care as close to the community as possible. Family doctors are the first to come into contact with the patient and have an essential role in identifying and directing cases to specialized services,” the minister noted.

The representative of the World Health Organization (WHO), Miljana Grbić, stressed that Moldova has made significant progress, but that the next stage must focus on the sustainability and strengthening of services.

“The World Health Organization has consistently supported the development of community-based mental health services in the Republic of Moldova, and what we see today is the result of a joint effort by the authorities and international partners. The Republic of Moldova has taken an important step by transitioning from a hospital-based model to services close to the community, which is fully in line with WHO recommendations on respecting dignity, promoting recovery and protecting human rights. The next essential step is to ensure the sustainability of these services. It is important to have stable funding integrated into the national health system, so that mental health services do not depend exclusively on projects, but become a structural part of the system. In addition, strengthening primary health care is crucial, as it represents the first point of contact for most people. Family doctors need to be supported through continuous training so that they can identify and manage cases of depression, anxiety, substance use or other associated disorders. Finally, we must ensure that the entire system is built on respect for human rights, on service quality and on reducing stigma.”

During its implementation, the project supported the development of the regulatory framework for community mental health services, contributed to piloting the reform in several districts, and to the expansion of the national network of community mental health centers, which now comprises approximately 40 units nationwide.

MENSANA also supported the professional training of specialists in the field – psychiatrists, family doctors, psychologists, social workers and medical staff – and promoted the integration of World Health Organization standards and human rights principles into the mental health system of the Republic of Moldova. Another important outcome of the project is the introduction of peer support services, as well as the development of social and professional inclusion programs for people with mental health problems.

According to the National Agency for Public Health, at the end of 2024 there were around 80,000 people with mental health problems registered in the Republic of Moldova. At the same time, community centers recorded over 200,000 visits, more than half of which came from rural areas. During the event, mental health reform ambassadors were awarded in recognition of their contribution to promoting change and strengthening community services.

MENSANA project was supported by the Government of Switzerland and implemented between 2014 and 2026 by the private institution “Trimbos Moldova”, in partnership with international organizations from the Netherlands, Switzerland and Romania, playing an essential role in the transition from an institutionalized model to modern community services focused on recovery and social inclusion.