Many emigrants are afraid to see a psychiatrist at all — and especially in a new country, in a new language. And there’s no reason to be. Exclusively for Xpat.Land, psychologist and cognitive therapist Maria Favorskaya explains how to get quality, affordable psychiatric care in Portugal across a range of situations: from a prescription for antidepressants to emergency hospitalization.
Seeing a psychiatrist here is nothing to be ashamed of — it’s quite ordinary. A recent study found that 47% of Portugal’s residents are diagnosed with a neurological or psychiatric disorder at some point in their lives. The country ranks second in Europe for the prevalence of psychiatric illness (found in 22% of the Portuguese population — only Ireland ranks higher). The most common diagnoses are anxiety disorders, depression, addictions, epilepsy, and age-related neurological conditions.
Psychiatric care in Portugal is fairly modern and grounded in evidence-based medicine. There is no such thing as a psychiatric registry here, of the kind that post-Soviet emigrants fear. Being under the care of a psychiatrist does not lead to any restriction of your rights, and information about it is strictly confidential.
Private Clinics
The simplest and fastest way to get help is to go to a private clinic. Portugal’s private medical sector is very well developed; psychiatrists and psychotherapists can be found in all the major medical centers and clinic networks — for example, CUF, Lusíadas, Hospital da Luz, and Trofa. CUF and Hospital da Luz have even been recognized as among the best private hospitals in Europe.
For walk-in patients, a single psychiatric consultation costs between 80 and 150 euros. If you have private health insurance, the price drops by 25–50 euros (depending on your policy). Openings in the next few days aren’t always available, but you’ll typically be seen within one to three weeks.
Notably, most younger doctors (and virtually all of them at private medical centers) speak English well. The languages a doctor speaks are usually listed in their profile on the clinic’s website.
Telemedicine
Telemedicine is available too: private clinics offer the option of a psychiatric consultation over video.
It’s very convenient: you book online through the clinic’s website or app. On the appointed day you connect by video, and immediately after the consultation you’ll be sent an electronic prescription (receita sem papel) by SMS.
You can find a doctor with the specialization you need and read reviews on sites like Doctoralia.
Public Healthcare
You can see a psychiatrist through the public system, the SNS (Serviço Nacional de Saúde), completely free of charge — provided, of course, that you’ve already obtained your health service user number (número de utente).
This route takes more effort. Psychiatrists, like many specialists, are in short supply in Portugal, and the wait to see one can stretch to many months. To get on that waitlist, you first need to see a general practitioner, describe the symptoms troubling you, and get a referral to a psychiatrist (referenciação).
How to Get a Prescription
There’s a way to skip the queues and get a prescription quickly. If you’ve previously been diagnosed and prescribed medication, you don’t have to wait for a psychiatric appointment. A general practitioner (clínico geral) or family doctor (médico de família) can renew your prescription — including one issued in another country.
To renew a prescription, go to your nearest Centro de Saúde (the equivalent of a public neighborhood clinic). Explain to the receptionist that you need a prescription for medication you’ve been taking regularly, and that your condition has worsened without it. Show a discharge summary from your clinic back home, translated into English or Portuguese. A standard form listing the diagnosis, the treatment regimen, the clinic’s name, and the doctor’s surname is enough. A certified translation is usually not required, so you can do it yourself. If you don’t yet have a family doctor, ask to be referred to an on-call doctor available in the near term.
You’ll need to go over the medication names and dosages with the doctor to make sure they’re listed correctly on the prescription — errors aren’t uncommon, and the pharmacy will only sell you the exact dosage and number of packs the doctor prescribed. On the plus side, you’ll have the option to choose between the original brand-name drug and a cheaper generic.
Keep in mind that a standard psychiatric prescription is valid for only one month, so you’ll have to buy several packs at once. For a chronic disorder or long-term treatment, ask the doctor to write a long-term prescription (valid up to a year). All your prescriptions — both from public and private doctors — will be visible in the SNS 24 app.
The advantage of official prescriptions in Portugal is that they entitle you to discounted medication. The government subsidy can cover as much as 50–90% of the drug’s price. Some generic antidepressants, for instance, can be bought for next to nothing — 30 to 50 cents a pack.
If You Don’t Have a Diagnosis
It’s possible to get a prescription from a general practitioner even without a diagnosis, as long as your symptoms are relatively mild and common — if you’re suffering from depression or anxiety, for example.
General practitioners are allowed to prescribe psychopharmaceuticals on their own — not all of them, but many common ones, such as antidepressants and anxiolytics. If these measures don’t help and a more complex diagnosis is suspected, your family doctor will refer you to a psychiatrist for evaluation.
Powerful psychotropic drugs are subject to special controls and can only be prescribed by a psychiatrist. These include many psychostimulants, antipsychotics, and sedatives. When buying such a medication, the pharmacy will ask to see your ID.
And If You Need a Hospital?
Emergencies happen too. Don’t delay if a loved one is losing touch with reality, is unable to control themselves, or is talking about suicide.
For an acute condition, go to a public hospital (Hospital). Portugal has no isolated psychiatric hospitals of the kind used to frighten many Russians. Psychiatric wards are set up within general hospitals, and they look just like any other hospital.
How to Be Admitted
There are several options:
- Call Linha SNS 24 (808 24 24 24) and explain what’s happening. There are operators who answer in English, though it often takes a long time to get through.
- Contact your family doctor and get a referral.
- Go to a public hospital yourself and ask for the Serviço de urgência psiquiátrica (psychiatric emergency service).
Psychiatric treatment of a relative requires their consent. Even serious disorders such as schizophrenia are, wherever possible, treated on an outpatient basis here.
Involuntary hospitalization is used only in the most extreme cases, and usually for a short period: when an acute episode makes a person a danger to themselves or others — that is, when they’re planning suicide or attacking other people.
