Getting an adult ADHD or autism assessment in Spain

Terms used

• Médico de familia — The médico de familia is your family doctor (GP) at your public health centre, who refers you to specialists.
• Unidad de Salud Mental — The Unidad de Salud Mental is the public community mental health unit where psychiatrists and psychologists assess adults after a GP referral.
• Tarjeta sanitaria — The tarjeta sanitaria is the health card issued by your region, linking you to a health centre and a GP.
• Padrón — The padrón is the municipal register of residents, and your town hall issues proof that you are on it.
• Certificado de discapacidad — The certificado de discapacidad is an official disability certificate issued by your region, which can give access to support and benefits.

Key rules

• Public route: Your GP must refer you; you cannot book the public mental health unit yourself.
• Private route: You can book a psychiatrist or clinical psychologist directly, with no referral.
• Stimulants: Only a specialist normally starts ADHD stimulants, and a GP usually does not.
• Foreign diagnosis: A diagnosis from abroad helps but often does not replace a Spanish reassessment.

The short answer

Adult ADHD and autism assessment is hard to get through the public system, so most newcomers end up paying privately. Stimulant medication is controlled: a specialist starts it, not a GP. Pick your route first. The decision and steps below help you do that.

The public route

Care is free if you have public health coverage. Your GP (médico de familia) is the gatekeeper. You describe your symptoms and the GP refers you to the community mental health unit (Unidad de Salud Mental), where a psychiatrist or clinical psychologist assesses you.

Expect a long wait. Adult ADHD services are patchy. Some regions have specialised units, but many mental health units have little adult ADHD experience and may decline you or send you elsewhere. For autism, the unit may pass you to a specialised autism unit, but only where one exists. If the unit declines, ask your GP where else you can be referred.

To use this route you normally need the regional health card (tarjeta sanitaria), which needs your padrón registration and Social Security affiliation. If you have no cover, you can ask for access once you have at least 90 days of registered residence. Procedures and waiting times differ by region. Your local health centre can tell you how it works in your area.

The private route

You book directly with a psychiatrist, a clinical psychologist or a specialised clinic. Online clinics exist too. You do not need a referral.

• ADHD: a full assessment typically costs about 200 to 600 euros. It usually includes an interview, your childhood history, rating scales and sometimes neuropsychological tests, followed by a written report. Psychiatrist follow-up visits typically cost about 60 to 120 euros each.
• Autism: assessment uses specialised tools and typically costs about 400 to 1,000 euros, depending on the clinic.

Prices vary by city and clinic, so ask for the total price before you book. Check that the assessor has experience with adults. Ask for the written report.

Medication

Methylphenidate and lisdexamfetamine are controlled medicines. A psychiatrist, or a specialist with experience, starts them, and they are prescribed on special controlled terms. Their authorised use for adults is limited, so doctors often prescribe them under specific conditions. A GP does not usually start them. In some regions a GP may continue treatment with specialist reports.

If you already have a diagnosis from abroad

Spanish doctors usually treat a foreign diagnosis as supporting evidence, not as proof. Many want their own reassessment before prescribing stimulants. Public services ask for this more often than private psychiatrists. A recent report from a qualified specialist, translated if needed, helps. Bring school reports, your medication history and your current prescriptions too.

After an autism diagnosis

A diagnosis can lead to a regional disability assessment (certificado de discapacidad). Ask the assessor for a full written report, because you will need it.

Choosing between options

Should you go through the public system or pay for a private assessment?

• Public route through your GP: You have a regional health card and a GP, and you can wait a long time. It is free, but adult ADHD and autism services are scarce and the unit may decline or redirect you.

• Private assessment: You want a faster answer or have no public coverage. You book directly and pay: about 200 to 600 euros for ADHD and about 400 to 1,000 euros for autism.

• Private assessment for a diagnosis made abroad: You already have a diagnosis from another country. Bring a recent specialist report, translated if needed; private psychiatrists are less likely than public services to ask for a full reassessment before prescribing.

If you have public coverage and can wait, start with your GP. If you need speed, have no coverage, or the public unit declines, go private.

Steps to an adult ADHD or autism assessment

From first visit to treatment

• Decide between the public and the private route: before you start

• Gather school reports, earlier diagnoses, medication history and the current prescription list, with Spanish translations of foreign papers, and ask a parent or relative to describe your childhood: before your first appointment

• Public route: see your GP (médico de familia) and describe your symptoms: first step on the public route

• Your GP refers you to the community mental health unit (Unidad de Salud Mental): at or soon after the GP visit

• Wait for the psychiatry or psychology appointment: commonly several months to over a year, depending on your region and area

• If your area has no adult ADHD service or the unit declines, ask your GP where else you can be referred, or consider the private route: if the unit refuses or redirects you

• Private route: book directly with a psychiatrist or clinical psychologist, or a specialised clinic, including online clinics: usually available within days to a few weeks

• Have the assessment: an interview, childhood history, rating scales and sometimes neuropsychological tests, ending with a written report. A full private assessment typically costs 200 to 600 euros: at the appointment, after the wait

• Agree a treatment plan: the psychiatrist prescribes and gives psychological support. Private follow-up visits typically cost 60 to 120 euros each: after diagnosis

• Keep up follow-up visits. Your GP may continue the prescription on the public route; on the private route you buy medication on a private prescription and can ask the public system to take over your care: ongoing after treatment starts

Documents you need

• Padrón certificate (empadronamiento): proof that you are registered at your address, issued by your town hall. You generally need it to get your regional health card.

• Regional health card (tarjeta sanitaria): issued by your region's health service, with a health centre and a GP assigned to you. You need it for a GP referral to public mental health services.

• Proof of Social Security affiliation, or if you have none, proof of at least 90 days of registered residence to request healthcare access.

• Diagnostic report (certificado de discapacidad application): after an autism diagnosis, the written report from your assessing specialist supports a regional disability assessment.

Checklist

• Ask your GP for a referral to the community mental health unit (Unidad de Salud Mental), expecting a long wait.

• Ask your GP what to do if the unit declines or has no adult ADHD service in your area.

• Ask private clinics for the total price: a full ADHD assessment typically costs about 200 to 600 euros, and an autism assessment about 400 to 1,000 euros.

• Check that the assessor is a psychiatrist or clinical psychologist experienced in adult ADHD or autism.

• Ask for the written report at the end of the assessment.

Frequently asked questions

Can a GP prescribe ADHD stimulants in Spain?

No, a GP does not usually start stimulants such as methylphenidate; a psychiatrist normally does. In some regions a GP may continue the treatment later, if a specialist report supports it. Stimulants are controlled medicines, so the prescription is issued on special terms.

Will a Spanish doctor accept my ADHD diagnosis from abroad?

Spanish doctors often treat a foreign ADHD diagnosis as supporting evidence, but they commonly want their own reassessment before prescribing stimulants.

How much does a private adult autism assessment cost in Spain?

A private adult autism assessment typically costs about 400 to 1,000 euros, depending on the clinic. It is usually done by a psychologist or psychiatrist specialised in autism, using tools such as ADOS-2 and ADI-R. After a diagnosis you can ask your region for a disability assessment (certificado de discapacidad).

What if I have no public health coverage?

You can use private care, NGOs or emergency care. If you have no insurance but have been registered as a resident for at least 90 days, you can request access to public healthcare. Public specialist services then go through a GP referral.