How Spain views therapy, medication and mental health

Key rules

• GP first: In the public system your GP is the entry point, and complex cases are referred on to the mental health unit.
• Short visits: Appointments are officially 5 to 10 minutes, so arrive with a written list and say up front it is about mental health.
• Medication-first: Anxiety medicines are prescribed often; if you prefer therapy, ask clearly for a referral to a psychologist.
• Attitudes: Openness about anxiety and depression is growing, but therapy is less routine than in northern Europe or the US.

The short version

Expect a short GP visit and a medication-first approach. Therapy is accepted, but it is less routine than in northern Europe or the US. If you know this before you go, you can ask for what you need.

How people in Spain see mental health

Attitudes to common problems like anxiety and depression have become much more open since the pandemic. People, including sports and media figures, now speak about it publicly. Seeking therapy is increasingly normal among younger people. It is less accepted among older generations and in some rural areas.

Stigma remains stronger around severe conditions such as schizophrenia, and in the workplace. Think about who you tell at work.

The government runs a mental health helpline, 024, and has a mental health action plan.

What to expect from a GP

Your GP (médico de cabecera) is the first stop in the public system. GPs handle mild to moderate anxiety and depression. Spain has one of the highest rates of anxiolytic and benzodiazepine use in Europe, and most of these drugs are prescribed by GPs. Antidepressant use has also risen steadily for 20 years.

So a short visit ending in a prescription is common. Public psychotherapy waiting lists are long and there are fewer psychologists per head, which pushes treatment towards medication.

Benzodiazepines need a prescription, and national guidance recommends short courses. If you would rather not start with medication, say so and ask about other options.

Complex cases go to the mental health unit (USM). Your GP makes that referral.

Visits are short, so prepare

An appointment is scheduled for 5 to 10 minutes and often lasts 7 to 10. Waiting for one can take days to weeks. Use the time well:

• Say at the start that the visit is about your mental health.
• Bring a short written list of symptoms, when they began and how they affect sleep, work and daily life.
• Ask for a longer appointment or a follow-up.
• Ask directly about referral to the USM or a psychologist.

The checklist below has the full steps. Length and waits vary by region and centre.

Checklist

• Book the appointment by phone, app or at your health centre (centro de salud).

• List the medicines you take now.

• Bring earlier medical records, with a translation if possible.

• Ask for a longer appointment or a follow-up, since visits are short.

• Ask about referral to the mental health unit or a psychologist.

• Bring a Spanish-speaking friend or an interpreter if your Spanish is limited.

Frequently asked questions

Will my GP just give me a prescription for anxiety?

Yes, quite possibly, because GPs in the public system handle mild to moderate anxiety and depression, often with a short appointment and a prescription. Benzodiazepines need a prescription and national guidance recommends short courses. If you want therapy as well, ask directly, since public psychotherapy waiting lists are long.

Is it normal to see a therapist in Spain?

Yes, it is increasingly normal, especially among younger people, though less so among older generations and in some rural areas. Attitudes to anxiety and depression have become more open since the pandemic. Therapy is still less routine than in northern Europe or the US, and the public system has fewer psychologists per head.

How long is a public GP appointment in Spain?

A public GP appointment is officially about 5 to 10 minutes, and in practice often lasts around 7 to 10 minutes. Waiting for an appointment can take days to weeks. Say at the start that it is about your mental health and ask for a longer appointment or a follow-up.