Now, things are different. Instead of waiting for the next breaking point, 31-year-old Iacob has a routine that brings support into ordinary weeks while he still lives at home, in the same village, with the same daily responsibilities. “I cut the wood, take my pills and also help others,” Iacob sums up.

“Me and other beneficiaries  gather at the medical point in my village. The car comes, takes us to the mental health centre where we’re welcomed with warmth and can work on ourselves. I don’t have insomnia anymore,” he explains. “I have a desire for life.”

Iacob’s grandmother says the centre’s specialists have even visited their home, and for her, that follow-up is the biggest change: support that stays close instead of vanishing after a hospital stay.

And this is a nationwide shift. It was built through MENSANA, a Moldovan–Swiss mental health reform project. Victoria Condrat, local manager of MENSANA project, says Switzerland’s financial and technical support has backed the changes for 12 years by investing in the architecture of the system.

Today this architecture includes 40 community mental health centres working across the country; around 78,000 people are using the mental health services provided by these centres.

“Switzerland stood with our country and gave us the breathing room to rebuild the system from the ground up,” Condrat adds.

Mental healthcare in Moldova

The Community Mental Health Centre that Iacob visits is located right in the building of Călărași district hospitalI. His psychologist, Izabella Eni, remembers that when Iacob’s mother brought him here, the team started working with him through multidisciplinary support. In practice, that means a coordinated team approach: psychiatric, psychological, and social support working together around the same person. But the journey hasn’t been that linear.

“After the first hospitalization, I slipped,” Iacob recalls. “I didn’t follow the treatment plan. Then came a second hospitalization.” He is referring to hospital stays in the psychiatric hospital in Chișinău . Then, in 2018, his mother brought him to the Community Mental Health Centre in Călărași, where he began receiving regular support while living at home in his village. 

After some time of working outside of Moldova, Iacob came back and started visiting the centre monthly. He was given a treatment plan, attended group meetings, and individual sessions. He admits there were “setbacks” and that it took time to stabilize. “Years of treatment lost. Years lost,” Iacob says.

Since last year, he has started helping others, too.

“I was selected by the doctor and the psychologist,” Iacob says. “They told me: ‘Iacob, we see you as a future specialist.’ I did the courses. Now, I’m doing peer support, I listen and talk to other beneficiaries.”

He underlines it: coming up to the centre is also about learning how to be useful to others as well as for himself, alongside the local professionals who carry the day-to-day work.

What Iacob sees in one centre is happening across Moldova.

Arriving to the centre when “it hurts inside”

For the psychologist Izabella Eni, the entry point for everyone should be on human terms. People arrive, she says, when they feel most vulnerable, when they can only put it simply: “it hurts inside.” They can reach the centre in different ways, through a psychiatrist, a family doctor or on their own.

Once someone starts a treatment, Izabella says, the work is rarely “one specialist, one visit.” The centre operates as a team that can accompany a person beyond the consultation room, sometimes all the way to their home. And sometimes the most urgent problem is brutally practical. 

“A person’s problem can be a lack of financial resources,” Eni explains. No money for firewood, no basics that make it possible to keep a routine. When that’s the reality, follow-up has to mean more than prescriptions: it means a plan made together, continuity, and a bridge between the person and the life they’re trying to hold together.

Iacob recognizes that kind of support in the smallest lessons, not in slogans. “The psychologist supports us and teaches us almost like a second mother,” he says. 

Closer to home, but away from gossip and judgement

Victoria Condrat describes the change in Moldova’s mental healthcare: “We shifted the focus from hospitalization and crisis situations to prevention, recovery, and an active life in the community,” she says. It’s now moved away from a system centred on psychiatric hospitals, toward services people can use without disappearing from their own lives.” 

For her, the reform is also about making the work consistent. She points to multidisciplinary teams that approach problems from more than one angle. They do clinical protocols for evaluation, diagnosis, and treatment. Recovery is built on the latest scientific evidence.

She also calls home visits a newer component of this model, sometimes carried out under constraints. In the Basarabeasca district, she says, a small team from the local centre has no car, so “they get on bicycles and go through villages to do home visits.”

The constraints Victoria Condrat describes are not only logistical, they’re social, too. Iacob says that even now some people continue to humiliate people with mental health issues as if stigmatizing were a habit they refuse to drop. But in his village he is not the only one connected to the centre: “There are four-five of us, we often go together to the centr in Călărași” he says. It is a quiet counterweight to judgment, people showing up side by side, week after week, not to make a statement, but to keep their lives workable.