Finding specialist treatment for an eating disorder in Spain

Key rules

• Public referral: Public specialist units are reached by referral from your GP and then the mental health service, not by booking directly.
• Regional gaps: Some regions have no dedicated eating disorder unit, so you may be referred to another region.
• Emergency: For fainting, severe weight loss, refusing fluids or suicidal thoughts, call 112 or go to urgencias.
• Private care: Private specialists, day hospitals and residential centres are available, and some insurance policies cover part of the cost.

The short route

In the public system, you start with your GP, or your child's paediatrician. They refer you to the local mental health service, and that service refers you on to a specialist unit. You usually cannot book a specialist unit yourself.

If the situation is urgent, skip all of this and go to hospital urgencias or call 112.

Public route, step by step

1. See your GP or paediatrician. Describe the eating difficulties plainly: what is eaten or avoided, weight changes, purging, fainting, mood.
2. Get a referral to the local mental health service. This is the CSM, or its child and adolescent equivalent for under-18s.
3. Ask the CSM for a referral to a TCA unit or day hospital. TCA is the Spanish term for eating disorders. These units treat eating disorders in a specialised, multidisciplinary way.

The checklist below lists these steps so you can tick them off.

Where the units are

Specialist units are mostly in hospitals in large cities and regional capitals, such as Madrid, Barcelona, Valencia, Seville and Bilbao. Some regions have no dedicated unit. Ask the mental health service which unit serves your area and whether it is in your region or in another one. Availability differs by region, so what you can get depends on where you are registered.

Private alternatives

Private care is often faster to start, and you can use it while you wait for a public place. Options include:

• A psychologist or psychiatrist who specialises in TCA.
• A dietitian (dietista-nutricionista).
• A multidisciplinary clinic that combines these.
• A day-hospital programme or a residential centre for more intensive care.

Individual sessions cost roughly 50-100 euros each. Day-hospital or residential programmes cost from several thousand euros per month, and residential care is at the top of that range. Prices vary widely, so ask for a written quote before you commit.

Some private insurance policies cover part of the treatment. Ask your insurer before you book, and ask which providers they accept.

When to go to urgencias now

Go to hospital urgencias, or call 112, if there are signs of medical instability:

• Severe underweight or rapid weight loss.
• Slow heart rate or low blood pressure.
• Fainting.
• Dehydration, or refusing food or fluids.
• Repeated purging that cannot be controlled.

Suicidal thoughts, self-harm or a psychiatric crisis also justify urgent care. So does outpatient treatment that is clearly failing. Do not wait for a referral appointment in these cases.

Choosing between options

The decision block below helps you choose between urgent hospital care, private outpatient care and a private day-hospital or residential programme. The FAQ answers common questions, including what to do if your region has no unit.

Choosing between options

Should you seek urgent hospital care, or arrange private treatment?

• Go to hospital urgencias now: There are signs of medical instability: severe underweight or rapid weight loss, slow heart rate, low blood pressure, fainting, dehydration, refusing food or fluids, or purging you cannot control.

• Private outpatient care: You are medically stable and want to start sooner than the public route allows. Individual sessions with a TCA psychologist, psychiatrist or dietitian cost about 50-100 euros each.

• Private day-hospital or residential programme: Outpatient treatment has not worked, or you need more intensive support. These cost from several thousand euros per month, with residential care at the higher end, and some insurance policies cover part.

If there is any sign of medical instability or danger, call 112 or go to urgencias first. Otherwise, choose private care by how intensive the support needs to be.

Checklist

• Book an appointment with your GP, or your child's paediatrician, and describe the eating difficulties.

• Ask the GP to refer you to the local mental health service (CSM, or the child and adolescent equivalent).

• Ask the mental health service for a referral to a specialist eating disorder (TCA) unit or day hospital.

• Look at private options while you wait: a psychologist or psychiatrist specialising in TCA, a dietitian, or a multidisciplinary clinic.

• Check whether your private insurance covers part of the treatment.

Frequently asked questions

Can I book a public eating disorder unit myself without a referral?

No, self-referral to a public specialist eating disorder unit is not usually possible. You normally need a referral from your GP or paediatrician, who sends you to the local mental health service first. That service then refers you on to a specialist unit or day hospital if one exists.

What if my region has no specialist eating disorder unit?

Some regions have no dedicated unit, so your mental health service may refer you to a unit in another city. Specialist units are mostly in large cities and regional capitals, such as Madrid, Barcelona, Valencia, Seville and Bilbao. Ask your GP which unit your region uses.

How much does private eating disorder treatment cost in Spain?

Individual private sessions cost roughly 50-100 euros each. Day-hospital or residential programmes start from several thousand euros per month, with residential care at the higher end.

Which signs mean an eating disorder needs emergency care?

Go to hospital urgencias or call 112 if there are signs of medical instability, such as fainting, a slow heart rate, low blood pressure, dehydration or refusing food or fluids. Rapid weight loss, suicidal thoughts or self-harm also justify admission.