How to get free psychological care through the SUS

Mental health care is a right of all Brazilians, guaranteed by various provisions in the Federal Constitution, the Child and Adolescent Statute (ECA), and regulations of the Ministry of Health. However, the demand for psychological care has been increasing exponentially, without the available infrastructure being able to accommodate it.

To give you an idea, one in three Brazilians feels anxious, reporting problems sleeping or eating frequently or frequently. A fifth has difficulty paying attention and concentrating, and about 25% have little interest or pleasure in their activities. These figures are from a Datafolha survey and were released in 2024.

In 2023, the Unified Health System (SUS) provided 27.9 million psychological consultations, a 23% increase over the previous year, according to the Ministry of Health. Even so, according to a survey by República.org, 9 out of 10 Brazilian cities have fewer than one psychologist per thousand inhabitants. In 400 municipalities, there are no official records of the presence of psychologists in the public health system.

According to Cristina Ventura Couto, from the Center for Research in Public Mental Health Policies at the Institute of Psychiatry at the Federal University of Rio de Janeiro (UFRJ), the solution goes beyond expanding access to psychological care; it also involves experiences of social belonging and combating poverty. "People are suffering greatly, yes, and they need care. This care, however, cannot be reduced to a single specialty, whether psychiatric or psychological; it needs to be addressed with multidisciplinary strategies that impact not only the individual but also their surroundings, their community. There can be no mental health without democracy and without improving social inequality," she adds.

How to get psychological care through the SUS

The structure dedicated to mental health care within the Unified Health System is the so-called Psychosocial Care Network (RAPS), which is divided into primary care, specialized care (which involves Psychosocial Care Centers, known as CAPS), emergency care, transitional residential care, hospital care and rehabilitation strategies.

The first step to requesting free psychological care, unless it's an emergency, is to go to a Basic Health Unit (UBS). Initially, the citizen must schedule an appointment with a general practitioner, explain what's going on, and request a referral to a psychologist. With this request, the person can schedule an appointment with the nearest professional.

It's worth remembering, as you read above, that some municipalities lack psychologists. Furthermore, due to high demand, the psychosocial care network prioritizes more urgent cases. Therefore, wait times for appointments can be long. According to data from the Instituto República.org, in Rio de Janeiro, it takes an average of about three and a half months for a patient to get an appointment, for example. In some cases, depending on the patient's symptoms and condition, the general practitioner refers the patient directly to the CAPS.

More possible alternatives

If you need psychological care and cannot find a timely appointment through the SUS, you can seek out Non-Governmental Organizations, collectives, and other institutions that provide support to specific groups, such as CVV for suicide prevention, Casa 1, focused on the LGBTQIAPN+ community, Prematuridade, which serves families of at-risk newborns admitted to neonatal ICUs, among other entities.

Another option is to seek support from universities. Many programs have teaching clinics, where interested students receive care under the supervision of professors. Inquire about openings and enrollment at each institution in your region, as the number of appointments is often limited.