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If you are experiencing anxiety, depression or another mental health issue and you are seeking support from the public system, the usual first step is to go to your local health centre.
Patients usually access the mental health network through Primary Care or Emergency services, although there are some exceptions and resources with direct access in certain autonomous communities.
Where does access to the mental health network begin?
In most cases, access to the public mental health system begins with your family doctor or primary care physician, who is usually the first point of contact. During this appointment, you explain what's happening to you, how you feel, and for how long, and the doctor assesses whether they can help you through primary care or if they need to refer you to a specialist.
Sometimes the family doctor provides the first approach, offering guidance and follow up, and may even start treatment with antidepressants (such as Vortioxetine). Only if the problem is more intense, long lasting or complex will a referral to the mental health unit usually be considered.
When are you referred to psychology or psychiatry?
You're referred to a public psychologist or psychiatrist when your doctor believes your case requires further evaluation or specific treatment. This usually happens if the distress interferes with your daily life, if there's a risk of self-harm, if you've already tried other measures without improvement, or if there's a medical history that warrants specialized follow-up.
In many cases, the referral can be made electronically, and you will be given an appointment at the local mental health center. There, they can offer psychotherapy, a psychiatric evaluation, or other resources depending on your situation and the service's availability.
Is it always mandatory to go to Primary Care?
In the standard mental health network circuit, Primary Care usually acts as a filter and you need a referral to see a public psychologist or psychiatrist.
Even so, in some communities there are specific mental health or addiction resources with direct access, without first going through the family doctor, especially for young people or for very specific problems such as behavioral addictions.
You can also enter the network after urgent care in a hospital, for example if you go to the Emergency Department for a serious crisis, and from there you are referred to a mental health center for follow-up.
What options do you have if you can't wait?
If the waiting list is long or you feel you need help as soon as possible, you can combine several options. One possibility is to contact municipal or university resources, patient associations, or telephone helplines for emotional support, which in many cases are free.
Another option is to consult privately while the public appointment is progressing, always verifying that the professional is accredited.
In any case, if a serious emergency arises, such as thoughts of harming yourself or others, you should go to the Emergency Room immediately or call the emergency numbers in your country.
And for routine follow-up and treatment changes, it's important that you always follow the instructions of your doctor, psychologist, or psychiatrist, who are the ones who can assess your specific case and adjust the help you need.
