Psychiatric emergencies and involuntary admission (ingreso involuntario)

Terms used

• Urgencias — Urgencias is the emergency department of a Spanish hospital.
• Ingreso involuntario — Ingreso involuntario is hospital admission for a mental disorder without the person's consent, supervised by a judge.
• Procurador — A procurador is the court representative who files documents and acts for you in court proceedings, alongside your lawyer.
• Ministerio Fiscal — The Ministerio Fiscal is the public prosecutor's office, which can represent and protect the person admitted.
• Defensor del Pueblo — The Defensor del Pueblo is Spain's national ombudsman, who takes complaints about public bodies.

Key rules

• Emergency: In a psychiatric emergency call 112 or go to hospital urgencias.
• 024 line: 024 is free, confidential and open 24 hours for crisis and suicide-prevention support, not for dispatching an ambulance.
• Urgent admission: The centre must tell the court within 24 hours, and the court must ratify within 72 hours of receiving the notice.
• Review: There is no maximum length, but reports are due at intervals of no more than six months.
• Legal help: You can appoint your own lawyer and procurador or be represented by the prosecutor.

Where to go in a psychiatric emergency

Call 112 or go to the urgencias (emergency department) of the nearest general hospital. General hospitals handle psychiatric emergencies, with a psychiatrist on call or a liaison psychiatrist. If life is in immediate danger, call 112: it sends an ambulance and, if needed, police. Many regions have English-speaking operators.

The 024 line is different. It is a free, confidential, 24-hour line for crisis and suicide-prevention support, run by the Ministry of Health. Use it to talk to someone, not to get an ambulance.

When admission can be involuntary

Involuntary admission (ingreso involuntario) applies to a person with a mental disorder who cannot decide for themselves. It is a procedure supervised by a judge, with set safeguards.

Normally the court must authorise the admission first. The court of first instance where the person lives decides. The hospital treating the person or a family member usually files the request, with a medical report.

Before ruling, the judge:

• examines the person in person;
• hears the prosecutor (Ministerio Fiscal) and anyone the person asks for;
• obtains a report from a forensic doctor.

The judge rules by a written decision (auto), which can be appealed.

Urgent admission

If the person must be admitted at once, the hospital can admit first and tell the court afterwards. The centre has to tell the court within 24 hours. The court must then ratify the admission within 72 hours of receiving that notice.

Rights of the person admitted

The person admitted has the right to:

• be heard and examined by the judge;
• appoint their own lawyer and procurador (the court representative who files documents), or be represented by the prosecutor;
• be told about their situation and their rights;
• appeal the court's decision;
• have the admission reviewed by the court at regular intervals;
• be discharged as soon as the doctors consider admission no longer needed.

Ordinary patient rights to information, privacy and dignity still apply, as do rights to communication and visits.

To complain, go to the centre, the court, the prosecutor or the Defensor del Pueblo (the national ombudsman).

How long it lasts

There is no fixed maximum. The judge sets a review period in the authorising order, and reports are due at intervals of no more than six months. The judge can ask for extra reports at any time.

The centre's doctors must report as soon as they think the admission is unnecessary. They discharge the person and tell the court.

Costs for visitors and non-residents

Hospitals do not refuse urgent psychiatric stabilisation to anyone, whatever their status. Uninsured foreigners, including irregular migrants, have access to public healthcare, and emergency care is guaranteed until medical discharge.

Visitors from the EU, EEA or Switzerland use their European Health Insurance Card and are generally charged only local co-payments. Other uninsured non-residents may be invoiced at the region's public prices. Privately insured visitors are normally billed through their insurer.

The timeline, checklist, warnings and questions below cover the steps and common worries.

Timeline and deadlines

• The centre tells the court about an urgent admission: within 24 hours of admitting the person

• The court ratifies the admission: within 72 hours of receiving the centre's notice

• The judge sets the review period in the authorising order: when the court authorises the admission

• The centre sends a progress report to the court: at intervals of no more than six months

Checklist

• Call 024 for free, confidential, 24-hour crisis and suicide-prevention support.

• Ask the hospital to give you a copy of the medical report if a court request is being filed.

• Ask whether the court has been notified, if the admission was urgent.

• Appoint your own lawyer and procurador, or ask to be represented by the prosecutor.

• Ask the doctors to report to the court as soon as they consider the admission unnecessary.

What to watch out for

• Delay in immediate danger: If life is in immediate danger, waiting or travelling on your own can cost time. Call 112, which sends an ambulance and, if needed, police. Call 112 straight away rather than going to hospital by yourself.

• 024 is not an emergency service: The 024 line gives crisis and suicide-prevention support but does not send help to your door. Use 112 when someone needs help in person now.

• Unexpected bills for non-residents: Hospitals will not refuse urgent psychiatric stabilisation, but non-residents without cover may be invoiced at regional public prices. Bring your European Health Insurance Card or your insurer's details, and ask about billing before discharge.

Frequently asked questions

Can the hospital admit me before a judge has approved it?

Yes, in an urgent case the hospital can admit you first, but it must tell the court within 24 hours.

Who can ask a court to approve an involuntary admission?

Usually the treating hospital or your family asks, with a medical report. The court of first instance where the person lives decides, after the judge examines the person and hears the prosecutor. A forensic doctor also gives a report.

Can I choose my own lawyer if I am admitted involuntarily?

Yes, you can appoint your own lawyer and procurador (a court representative), or be defended by the prosecutor instead. You can also appeal the court's decision.

Who can I complain to about an involuntary admission?

You can complain to the centre, the court, the prosecutor or the Defensor del Pueblo, Spain's ombudsman. Your rights to information, privacy, dignity, communication and visits continue during the stay.

Will a tourist be billed for emergency psychiatric care?

It depends on your cover: visitors from the EU, EEA or Switzerland using the European Health Insurance Card are generally not billed beyond local co-payments.