Change Seen Through the Eyes of Prisoners

Early summer sunlight falls across the garden at Pavilion D of the Dubrava Correctional Centre as "Prisoner S" walks among the plants cultivated by prisoners. Gardening forms part of a structured occupational therapy programme delivered by the Prison Healthcare Department (PHD) of the Ministry of Health of Kosovo through clinical psychologists and healthcare staff working inside the institution. Alongside meditation, group sessions, sport and fitness activities, it gives prisoners a daily routine built around participation, responsibility and rehabilitation.

Prison reform rarely makes headlines. There are no ribbon-cutting moments, nor a single day when everything changes at once. Instead, change takes shape gradually, through professionals learning and applying new ways of working, through persons in closed institutions being treated with greater dignity, and institutions gradually becoming more than places of confinement. In Kosovo*, this shift has been steadily unfolding over nearly a decade shaped by a sustained partnership with the Council of Europe. This is not merely a story of project cycles or policy documents, but of what genuine and lasting reform looks like in practice.

Prisoner S's experience captures the purpose of the wider reform, namely turning European standards into changes that people can experience in their daily lives.

From Custodial Control to Rehabilitation

At the institutional level, this transformation is reflected in a gradual but important shift in how correctional work is understood. Ridvan Hoti, the Permanent Secretary of the Ministry of Justice of Kosovo and former Deputy Director General of the Kosovo Correctional Service (KCS), explains: "Over these years, the way correctional staff work has changed significantly, from a system focused mainly on custodial control to one that increasingly recognises rehabilitation and dynamic security as central to prison management. Positive developments have also been seen in prisoner rehabilitation. In particular, the introduction of occupational therapy as an alternative or complementary approach to pharmaceutical treatment has produced encouraging results." He also highlights the strategic foundation of the reform: "With the support of the Council of Europe, the KCS has also strengthened its strategic and operational approach, including through the development of the KCS Strategy 2023-2027, which provides an important roadmap for future operations and institutional development in line with Council of Europe standards, and the introduction of tools for the early detection of self-harm and suicide risks, which have already proven effective in strengthening prevention and contributing to a more structured, protective and rehabilitation-oriented prison system."

The Strategy is further reinforced by modernised KCS training curricula that place rehabilitation and dynamic security more firmly within professional practice. The reform has also introduced tools for documenting and reporting possible ill-treatment and has advanced the development of a structured rehabilitation programme for prisoners with substance-use disorders. Together, these measures show how reform is being embedded through policy, procedures, staff development and practical tools rather than delivered as a series of isolated activities.

Health Safeguards That Protect Lives

The impact of reform is felt most sharply when a person is at risk. Milazim Gjocaj, Head of the PHD of the Ministry of Health of Kosovo, describes how the service has been strengthened through a more structured and sustainable framework: "Comprehensive Standard Operating Procedures were developed for the first time, providing a structured framework for the delivery of healthcare to prisoners, including mental healthcare, in line with medical ethics and professional standards."

The numbers tell a quiet but powerful story. According to data reported by the Prison Health Department, approximately 280 persons were identified as being at risk of suicide and placed within a system of enhanced assessment, monitoring and support; 21 suicide attempts were recorded during the reporting period. This response relies on clinical psychologists working daily inside institutions, a dedicated multidisciplinary commission and round-the-clock monitoring of those at greatest risk. Gjocaj adds: "12 out of 13 recommendations from the European Committee for the Prevention of Torture (CPT) have now been implemented. That is not a statistic. That is the result of years of dedicated, structured work, and it represents lives protected."

Rights Based Care Beyond Prisons

The reform process extends beyond prisons. At the Special Institute for Person with Mental and Learning Disabilities in Shtime/Štimlje (SIS), which provides care for persons with intellectual and psychosocial disabilities, a quieter but equally significant transformation has taken place. Xhemajl Dugolli, the Institute's Director, reflects on what the partnership has meant in practice: "For us, the strong and sustained cooperation with the Council of Europe has gone beyond supporting reforms and delivering training; it has directly contributed to improving the daily life, dignity and protection of the persons placed in our care. As the first international organisation to provide structured support to the SIS, the Council of Europe has played a pivotal role in strengthening our institutional capacities. One of the most significant contributions has been the development of Standard Operating Procedures, which have provided, for the first time, a clear and comprehensive framework for delivering rights-based care and treatment."

Important progress has also been made at the Institute of Forensic Psychiatry of Kosovo (IFPK). Although it operates within a distinct legal and institutional context, the IFPK has benefited from Council of Europe support to strengthen professional standards, rights-based treatment and alignment with European standards. Occupational therapy has helped translate these principles into daily relationships between staff and patients. Yllka Kryeziu, a social worker at the IFPK, explains: "I am one of the professionals whom patients trust the most. A patient who was once isolated now turns to me, speaks freely and believes that someone is truly listening. This is why I believe occupational therapy training was a turning point for me as a professional: I can genuinely see results." The project also supported the IFPK in moving from individual practice towards a shared institutional framework. Arife Veselaj, Specialist in Clinical Psychology at the IFPK, notes: at the Institute, project support has increasingly contributed to a more rehabilitation-oriented approach, with greater emphasis on meaningful activities, social interaction and practical skills as part of treatment and recovery. A study visit to Austria provided us with first-hand exposure to how dedicated spaces for music, movement and social interaction can support patients’ dignity, autonomy and rehabilitation. Importantly, this learning has begun to translate into practice, inspiring the development of new spaces and activities at the Institute and contributing to a more therapeutic environment focused on patients’ recovery and eventual reintegration into everyday life

The impact becomes visible through ordinary but deeply human tasks: making a bed, preparing a meal or learning a skill that may support a future job. Sebahate Koliqi, Head Nurse at the IFPK Admissions Office, captures the purpose clearly: "The goal is never just to occupy patients' time; it is to help them reintegrate into everyday life. It is not simply treatment within these walls, but preparation for future beyond them."

Another important partner in the implementation of our work is the National Prevention Mechanism (NPM) of the Ombudsperson Institution in Kosovo.Through independent monitoring, findings, recommendations and follow-up, it has contributed to improving standards of healthcare and rehabilitation for people deprived of their liberty. One such example is the introduction of occupational therapy, treatment that helps improve person’s ability to perform daily tasks.

Shqipe Ibraj Mala, Head of the NPM explains the importance of such treatment: “Life in a closed environment can involve inactivity, loss of routine, social isolation, mental health problems and dependence on staff. These factors can make it difficult to return to an independent life after release. Occupational therapy enables people to improve their physical, psychological and social functioning, as well as their ability to carry out daily activities.”

She further elaborates that monitoring treatment and rehabilitation conditions has helped establish the institutional foundation for integrating and developing occupational therapy services.

From Project Results to Lasting Practice

Reform is a direction rather than a destination.

The lasting value of the Council of Europe's partnership lies not only in the standards, strategies and tools developed, but in the capacity and ownership built within the institutions that use them. Together with the Ministry of Justice, the Ministry of Health, Kosovo Correctional Service, Prison Health Department, Institute of Forensic Psychiatry, Special Institute of Shtime/Štimlje, National Prevention Mechanism and civil society, a strong foundation has been laid.

Work ahead is to ensure that these reforms are applied consistently, monitored responsibly and sustained beyond individual project cycles so that dignity is protected in everyday practice, for every person deprived of liberty.

For Prisoner S, the purpose is already clear. A calmer morning. A task worth doing. Another small step towards recovery. That is where reform meets daily life—and where dignity must be protected.