Psychiatric hospitals in North Macedonia face scrutiny over patient safety

The death of student Christian Josip Periš at the Jankomir psychiatric clinic in Zagreb has reignited concerns across the Balkans about who protects psychiatric patients — and those questions resonate in North Macedonia, where institutions still struggle with infrastructure, staffing and oversight.

Patients in psychiatric hospitals often remain unseen by the wider public and dependent on a system that should safeguard their rights. In North Macedonia clinicians and relatives say overcrowding, dilapidated buildings and limited personnel leave vulnerable people exposed to neglect and violence.

“We continuously warn about the huge increase in the number of court rulings, where [people] are sent to the prison wards in psychiatric institutions and their overload relative to available staff and how many people can be cared for. All of that leaves a risk for inadequate treatment,” said Sasho Klekovski, Minister of Health.

Klekovski says the ministry is investing to improve living conditions, hygiene and nutrition, pointing to reconstruction work at Negorci. “We have started a cycle of reconstruction at Psychiatry Skopje in Bardovci where the first building was put into use, next year another building will follow. Because for them due to wear and tear there is not a single reconstruction every ten years but the process must be continuous and the situation in Demir Hisar remains critical where we are seeking investment, funds to build a new facility because the existing ones are far from any usable condition,” added Klekovski.

Incidents that shaped public debate

North Macedonia has seen its own serious incidents. Last year, in the hospital at Bardovci, a patient housed in a court ward killed another patient with a glass bottle; the convicted patient was later moved to the Šutka prison. Disturbing video from the same institution showed a newly arrived patient being physically attacked by other patients, reportedly a pattern within the court ward where people convicted of serious crimes are placed.

Photographs and footage published at the time revealed ruined rooms, crumbling walls, broken doors and windows, toilets without doors and conditions unfit for personal hygiene. Those images focused attention not only on infrastructure but on staffing levels, supervision and who is accountable when patients’ safety is compromised.

As the region watches developments in Zagreb, health advocates and families in North Macedonia call for clearer oversight, transparent investigations and independent monitoring to ensure psychiatric institutions protect — rather than endanger — those in their care.

Photo: press material from the event