Accessing mental health services in Spain

In Spain, public mental healthcare is available through the national health system, but access can be limited – especially when it comes to therapy. If you’re looking for a psychologist or counselor, you will likely encounter long wait times and limited session availability. For expats, other challenges may include language barriers, unfamiliar referral processes, and a greater reliance on private care for timely support.

To help you understand how to access mental health services in Spain, this guide includes the following:

Mental healthcare services in Spain

The Ministry of Health (Ministerio de Sanidad) oversees the provision of mental healthcare in Spain and focuses mostly on policy and budget. The Confederation of Mental Health in Spain (Confederación de Salud Mental en España) works closely with the government to provide equal access to different mental healthcare providers throughout the country.

As healthcare in Spain is decentralized, there are significant territorial inequalities when it comes to accessing mental healthcare throughout the country. Therefore, where you live is likely to make a difference in the quality of provision available.

It is important to be aware that if you choose to use free state healthcare as an expat, it will not cover all treatments, such as psychotherapy. For this reason, many people opt to pay for private health insurance which provides wider access to treatments and facilities. You can read more about this further down the guide.

How to access mental healthcare services

If you are living and working in Spain, you are entitled to the same free state healthcare as a Spanish citizen. Any dependents are also covered if they live in Spain. If you are an EU/EFTA resident, you can use the European Health Insurance Card (EHIC) to receive the same medical treatment as a Spanish national. However, free healthcare will not cover all treatments.

If you need to access mental healthcare services in Spain, you need to follow three steps. The first step is to visit your GP (médico de cabecera) who can prescribe drugs if necessary.

The second step is to seek a referral to other doctors, or for specialist treatment (atención secundaria o especializada), if required. Most of this is provided by community health centers. And the third step involves being treated for serious mental health problems in psychiatric hospitals, daycare centers, and rehabilitation centers.

You can find out what services might be available in your area of Spain by searching the Directory of Mental Health Associations (Directorio de Asociaciones de Salud Mental). Sites like SaludOnNet can help you compare different private providers.

Is therapy covered by insurance in Spain?

Therapy is only partially covered by Spain’s public healthcare system. While psychiatric care is included and accessible via referral from a doctor, access to public psychologists is limited and often reserved for more serious mental health conditions.

Talk therapy – such as cognitive behavioral therapy or counseling for anxiety, depression, or relationship issues – is rarely available through the public system, and when it is, long wait times and session limits are common. On average, a one-hour session with a therapist costs around €80–120, but this price can fluctuate by location and their professional specialization.

To help cover these costs, international health insurance providers offer plans tailored to expats that often include mental health coverage and access to English-speaking professionals.

A few of the largest international health insurance companies in Spain that offer mental health coverage as part of some expat plans include:

• Allianz Care
• APRIL International
• Cigna Global

With private health insurance, you don’t need a referral to see a mental health professional of your choice; you can simply search for one in your area using the following directories:

• English-Speaking Healthcare Association (ESHA) – a directory of psychiatrists who can treat you in English
• The National Association of Clinical Psychologists and Residents (ANPIR) – a directory of psychologists (in Spanish)
• International Therapist Directory – a global network of therapists working in many parts of the world; you can search by location

Drug and alcohol mental health services in Spain

If you’d like professional help to drink less or use fewer drugs, there are public and private options available in Spain; both inpatient and outpatient. If you choose to go through the public healthcare system, you will likely face longer waiting times and will need to go through your GP first. 

By contrast, private treatment centers offer reduced waiting times and give you more choice when it comes to treatment and care. That said, this is an expensive option if you don’t have private health insurance to cover at least some of the costs. 

Some of the main substance abuse services in Spain include:

• Ministerio de Sanidad (Ministry of Health) – provides information, links, and advice for those struggling with substance abuse problems (in Spanish) 
• Alcohólicos Anónimos (Alcoholics Anonymous) – has support groups all over the country
• Fundación de Ayuda contra la Drogadicción (drug addiction support) – provides a support hotline (900 161 515) and consultation service
• Narcóticos Anónimos (Narcotics Anonymous) – offers a support hotline (952 858 522) and online support (in Spanish)

Spanish health services dealing with eating disorders

Like in other European countries, there has been a rise in eating disorders in Spain in recent years. This is particularly acute among young women and teenagers. In recognition of the problem, schools across the country have implemented prevention programs in order to raise awareness. Healthcare professionals are also more aware of the problem. Meanwhile, the Association Against Anorexia and Bulimia (ACAB) offers an initial consultation with free advice and support.

If you require help for an eating disorder and want to seek support through the public healthcare system in Spain, you will first need to see a family doctor. They will then refer you to a specialist. Treatment typically involves a team of professionals with different areas of expertise.

Just bear in mind that you could be waiting several weeks to be seen unless you have private health insurance. As previously mentioned, there are many treatment options available for those who have private health insurance; however, some of them can be costly.

Mental health services in Spain for children and young people

If you have dependents living with you in Spain, they will also be eligible for public healthcare. This includes free pediatric and dental care until the age of 15. Beyond this, children with ongoing mental health illnesses can receive extended free healthcare. However, treatment is unevenly distributed across Spain and will largely depend on where you live.

Your family pediatrician will give you a referral to see a specialist who can help with a specific problem or diagnosis. However, again, this can take several weeks. That said, you can substantially reduce the waiting time if you have private health insurance or decide to pay out of pocket.

Hospitals can offer inpatient or outpatient care, depending on the severity of the illness. However, state healthcare will not cover all treatment, therapists, or counselors. Moreover, if you find an independent treatment center for a specific problem, it will incur costs.

Interestingly, there is a movement in Spain towards recognizing that schools (link in Spanish) have a role to play in preventing mental health problems such as anorexia and bulimia. There is also a growing awareness of these disorders throughout the country.

Mental healthcare for special groups

Several organizations in Spain offer mental health support tailored to specific groups. For women, this includes services for those affected by gender-based violence, sexual abuse, or challenging life events like divorce. The Fundación Mujeres provides a list of relevant resources (in Spanish).

If you have a disability, the Servicio de Información sobre Discapacidad – SID (Service of Information for the Disabled) provides a number of resources and a list of organizations (in Spanish) that offer support.

LGBTQ+ people in Spain can access mental health support through various local and national organizations. These include FELGTBI+ (Federación Estatal LGTBI+), which advocates for LGBTQ+ rights and can connect individuals with support networks. Some regional LGBTQ+ centers also offer free or low-cost psychological services, especially in cities like Madrid, Barcelona, and Valencia.

For refugees and asylum seekers, the Spanish Commission for Refugee Aid (CEAR) and the Red Cross (Cruz Roja) offer mental health and psychosocial support as part of their broader assistance programs. These services often include trauma-informed care, legal guidance, and help navigating the healthcare system.

Help for those with severe and long-term symptoms

In cases of severe mental illness requiring hospitalization, a psychiatrist will determine the treatment plan and discharge timing. Involuntary hospitalizations must be authorized by a judge.

Spain also recognizes advance healthcare directives (declaración de voluntad anticipada), allowing individuals to outline their treatment preferences. However, these directives are not widely used or always followed in mental health settings, so their impact may be limited in practice.

Emergency support and crisis lines in Spain

In any life-threatening emergency, call 112, the pan-European emergency number. Operators can usually assist in English and will direct you to police, ambulance, or fire services as needed.

Here are some of the main emergency support lines in Spain:

• Samaritans in Spain – an English-language helpline that offers free support by calling 900 525 100 or visiting the website
• Suicide, crisis, and support line (El Teléfono de la Esperanza) – offers support when you call the hotline 902 500 002 or visit the website

Useful resources

• Ministry of Health (Ministerio de Sanidad) – provides information about mental health services and strategies
• Confederation of Mental Health in Spain (Confederación de Salud Mental en España) – a directory of mental health providers by location