Bulgaria is a country known for its rich cultural heritage and picturesque landscapes. The population is roughly seven million and the nation is part of the North Atlantic Treaty Organization (NATO) and the European Union (EU). It is a hotspot country for historians and anthropologists alike, as it is one of the first European countries in existence. Bulgaria is dotted with mountains and dense with forests and it borders the sea, so there are several tourist attractions and opportunities for outdoor adventure. Here are five facts about mental wellness in Bulgaria.

5 Facts About Mental Wellness in Bulgaria

1. Historically, Bulgaria has not prioritized the mental health of its citizens, with very few mental health facilities in existence before the ’50s. After the regime change in 1944, psychiatrists in Bulgaria began to advocate the “dispensary system,” which meant to integrate and normalize psychiatric intervention in the broader citizen sphere. This mentality was born at a time when psychiatrists began to see the direct influence of “social conditions” on the mental well-being of citizens. Thus, psychiatry and outpatient treatments were introduced more readily to accommodate mental wellness in Bulgaria.
2. Social stigma is a significant barrier to addressing mental health in Bulgaria. Despite psychiatric efforts in the 20th century to incorporate psychiatric care into society, attitudes surrounding mental illness and disabilities in Bulgaria do not reflect these efforts. Seeking help can often target individuals and warrant social scrutiny – “Mentally ill are socially discriminated.” It is believed that the mentally ill themselves are guilty of their doom and they should not expect society to share the burden of disease with them.”
3. Regardless of rampant social stigmas, mental illness is highly prevalent in Bulgaria. According to the United Nations Children’s Fund (UNICEF), about 20% of children and adolescents experience mental health complications each year. Bulgarian youth are also ranked number one in Europe for unhealthy coping mechanisms, such as nicotine intake and drug/alcohol abuse.
   Though many doctors are not readily diagnosing mental health disorders in Bulgaria, it is estimated that nearly one in five Bulgarians experience depression to some degree: “People are told to just snap out of it and get on with their lives and are branded as sensitive and fragile.” Every year, nearly eight hundred Bulgarians succumb to suicide.
4. Several factors contribute to poor mental health in Bulgaria, the foremost being the lack of assistance for those in need, as previously mentioned. The health care system in Bulgaria does not prioritize mental wellness, which is often seen as separate from physical well-being and not as immediate. Additionally, though substance abuse is usually a result of mental health disorders, it can also be an instigator of such ailments.
   “According to data from the Bulgarian Methadone Association and the Bulgarian Institute for Addictions, there are more than 300,000 drug addicts in Bulgaria.” Health care is also widely inaccessible, with almost half of all medical payments requiring “out-of-pocket” compensation. Finally, nearly 40% of the population is impoverished to some degree, which amplifies mental health struggles disproportionately.
5. Luckily, steps are being taken to combat social stigmas around mental health disorders and provide resources to those affected. In 2018, the World Health Organization (WHO) implemented mental wellness interventions in Bulgaria. These interventions included providing mental health training to medical professionals, donating funds to support mental health services, creating programs to raise awareness and collaborating with policymakers to establish sustainable solutions. 

WHO’s initiative made a sizeable impact: “In 2018 and 2019, the suicide rate in Bulgaria decreased by 7% compared to the previous biennium.” Similarly, UNICEF is creating an app for young Bulgarians to provide information about mental struggles, personal care advice, links to mental health resources and more. It also strives to create a website that connects Bulgarian youths with mental health professionals.

Though efforts are being made to promote mental wellness in Bulgaria, more can be done to address the ongoing mental health crisis. Government intervention, as well as assistance from WHO, UNICEF and related organizations, is essential in steering the population to a more healthy and optimistic future. With the reduction of social stigmas, a decrease in barriers to health care and the integration of psychiatric care into everyday medicine, Bulgarians can begin to heal themselves holistically for years to come.

– Anna Williams

Anna is based in Burlington, VT, USA and focuses on Good News and Global Health for The Borgen Project.

Photo: Flickr