On an annual basis, the Government of the Republic of North Macedonia adopts the Program for Health Protection of Persons with Mental Disorders. The programme targets the general population and does not specifically focus on young people.

Given the absence of a youth-specific mental health strategy, the Regional Cooperation Council (RCC), in cooperation with the National Youth Council of Macedonia, initiated the drafting of a National Strategy for Youth Mental Health 2024–2026. The main objective of this strategy is to build an intersectoral support system for young people, involving close cooperation between the Ministry of Health, Ministry of Education and Science, and the Ministry of Social Policy, Demography and Youth as well as civil society and the academic community.

The National Youth Strategy for Mental Health 2024–2026 was adopted and officially presented in January 2024 at the 221st session of the Government. Its overall mission is to address current mental health challenges faced by young people and to promote a comprehensive, integrated and evidence-based approach to mental health promotion, prevention and service provision. Three core goals were identified:

• promoting the importance of mental health and well-being among young people;

• reducing risks associated with youth mental health;

• developing and implementing accessible, high-quality mental health services for young people.
   

The Strategy also contains an Action Plan that outlines concrete measures, responsible institutions, timelines and implementation dynamics. Each relevant institution is expected to integrate these activities into its annual programme and budget planning.

The Health Strategy of the Republic of North Macedonia 2021–2030 is the overarching framework for improving population health, including mental health. It foresees further development of community-based, locally focused mental health services, alongside specialised service areas such as forensic psychiatry, addiction services, and child and adolescent psychiatry.

Mental health policy in North Macedonia was initially developed in 2005 and is based on 11 key pillars, including deinstitutionalisation, strengthening community mental health services, mental health promotion, protection of human rights, user participation, equitable access, financing, quality assurance and monitoring. The Law on Mental Health, adopted in 2006 and amended in 2015, establishes the rights and responsibilities of persons with mental health conditions. Article 34 stipulates the establishment of a Committee for Mental Health within each municipality, allowing local monitoring of rights and services. However, only a limited number of municipalities have formed such committees, and their work is neither publicised nor widely disseminated.

These strategic documents address the mental health of the population broadly, but do not include a detailed youth-specific focus.

A more concrete direction appears in the National Youth Strategy 2023–2027, which includes a specific Strategic Goal (Thematic Area 2, Goal 2) dedicated to improving the mental well-being of young people. Planned measures include:

• opening and revitalising Mental Health Centres across the country, offering electronic consultations to improve access, particularly for young people in rural areas and those at risk;

• establishing psychological counselling services in all higher education institutions;

• creating a communication network with relevant authorities to identify and report violence, prevent substance abuse, internet addiction and early behavioural disorders;

• amending mental health legislation with a youth-focused preventative approach;

• improving access to services for young people with disabilities and their families;

• expanding and updating available medication for youth mental health treatment;

• training school psychologists, teachers and parents to better identify and respond to mental health challenges;

• strengthening the well-being of working youth through burnout prevention and workplace mental health support.

Health care for persons with mental health problems is organised across three levels of care. Primary care physicians are the first point of contact and provide referrals to higher levels. Secondary care includes specialist outpatient services and two Institutes for Children and Youth in Skopje and Bitola. Inpatient treatment is available in general hospitals, while the most severe cases are referred to psychiatric hospitals and the University Clinic of Psychiatry.

Monitoring of the Law on Mental Health and the Strategic Plan is the responsibility of the National Mental Health Committee and the National Coordinator for Mental Health, appointed by the Minister of Health. Although monitoring is based on defined indicators, reporting is not regular or fully complete.