Guidance

Mental health support for British nationals in Brazil

Updated 28 January 2025

Support for British nationals experiencing mental health difficulties in Brazil

The information contained in this note is intended for your general guidance only, it is not a substitute for obtaining your own medical and legal advice. While all due care has been taken in compiling this information, accuracy cannot be guaranteed, and the applicable law and procedures may occasionally change. For these reasons neither His Majesty’s Government nor any member of the British Consular staff can accept liability for any costs, damages or expenses which might be incurred.

The Foreign, Commonwealth & Development Office holds and uses data for purposes notified to the Information Commissioner under GDPR and the Data Protection Act 1998 (which may be viewed at www.ico.org.uk). Such personal data may be disclosed to other UK Government Departments and public authorities.

FCDO Consular Support

Whenever possible we will seek your permission before taking any action on your behalf.

We can:

• listen to you and help you look at your options

• help you to contact friends and family members if you want to

• visit you in hospital or prison in line with our usual procedures

• raise any concerns about your treatment or welfare with the responsible authority (such as a hospital or prison)

• help overseas medical staff contact medical staff in the UK who may be able to provide advice on your medical history

• give information about local medication suppliers

• be available, as appropriate, to offer you assistance if you choose to remain overseas

• Liaise with your travel rep or travel insurance company, if you want us to

We cannot:

• give advice on mental health issues

• buy or supply medication

• withhold or remove a passport

• stop you from travelling abroad

• require you to return to the UK

• pay for you to return to the UK

• pay for food, accommodation or medical bills

• get you better treatment in hospital or prison than is given to local people

What to do if you need help

If there is an emergency or urgent need for medical attention, you should either:

• call 192 for the Serviço de Atendimento Médico de Urgência (SAMU), the public ambulance service in Brazil.

• go to a Centro de Atenção Psicossocial (CAPS), Psychosocial Care Centre or, in smaller cities, a Unidade de Pronto Atendimento (UPA), an Emergency Health Centre.

SAMU, the ambulance service, is trained to handle psychotic episodes, but if the patient is aggressive, the police might be called for additional support. The patient would then be transferred to a CAPS psychiatric hospital or psychiatric unit at a general hospital for further care.

Universal healthcare in Brazil

Brazil has a national healthcare system called Sistema Único de Saúde (SUS). This system is free and available to everyone, including foreigners visiting or living in Brazil.

While SUS operates throughout the country, healthcare services are managed by local governments (municipalities). This means that availability and quality of services can vary depending on where you are in Brazil.  Emergency care is usually quick and reliable but waiting times for routine appointments and exams can take a long time

Please do not expect that healthcare workers will speak English to you. The language barrier is an issue in Brazil and only a small percentage of the population speaks English or other languages.

For mental health purposes, SUS operates in three different levels of care:

Primary Care: Unidades Básicas de Saúde (UBS)

Basic Healthcare Centres (UBS) provide general health services with support from multiple areas, such as nursery, psychiatry, psychology and others. UBS also have family doctors (médicos da família) who work on a similar way as GPs in the UK. They make first contact and assess your situation, offer initial help, and if necessary, refer you to a psychologist, psychiatrist, or more specialised mental health service.

Secondary Care: Centros de Atenção Psicossocial (CAPS)

If you need more specialised mental health care, the next step is to visit CAPS, a Psychosocial Care Centre. These centres are dedicated to mental health services and provide a range of services, including group and individual therapy and community-based support. They provide walk-in services, so you don’t need an appointment to receive help. Staff are trained to offer:

• home visits if you’re unable to travel
• ambulatorial services for ongoing treatment
• crisis stabilisation for urgent issues
• hospitalisation for a more intensive care is needed

They can also carry out assessments, make referrals and provide stabilisation and medium-term case services if you are experiencing significant mental health difficulty.

Third level Care: General and psychiatric hospitals

This refers to psychiatric hospitals and general hospitals that have psychiatric beds. These facilities can look after you if you have severe mental health episodes over the long term. Once a patient’s condition is stabilised, refer them to secondary or primary or secondary care. For less urgent mental health concerns, patients can visit a UBS (Basic Health Unit) or CAPS (Centre for Psychosocial Support) for primary mental health attention. CAPS services are recommended in big cities, as they are specialised entirely in mental health support.

Repeat or replacement prescriptions

If you are visiting Brazil and need a repeat or replacement prescription, CAPS (Centres for Psychosocial Care) may be able to assist. If your prescription is in a language other than Portuguese, pharmacies may not be able to provide the medication. In such cases, you should visit a CAPS for reassessment and to receive new prescription.

If you are a resident in Brazil, you can access prescription medication through the family physician team at your local UBS (Basic Health Unit).

Once you have a prescription, you can obtain medications approved by the SUS- (Brazil’s public health system) free at UBSs (Basic Health Unit) and UPAs (Emergency Care Units). While SUS medications are free, some specific drugs may require additional paperwork. Alternatively, you can purchase prescription drugs at private drugstores, which are broadly available throughout the country.

Compulsory hospitalisation

Brazilian law states three types of psychiatric hospitalisation:

Voluntary: patient consents to be hospitalised.

Involuntary: patient does not consent, but medical teams determine hospitalisation is necessary. There is no set time frame, and family approval is not required. However, the public prosecution office (Ministério Público) must be informed periodically by the medical team of the reason for the hospitalisation to ensure the patient’s rights are being upheld to prevent any abuse/mistreatment.

Compulsory: patient does not consent. This can only occur with both a medical and judicial order. A family member can request compulsory hospitalisation, but it must be approved by a judge. After approval, the patient might be referred to CAPS (Centres for Psychosocial Care) or general hospitals. In some cases, compulsory hospitalisation may be part of a broader legal process called Interdição(sectioning), where a guardian is appointed to make decisions on the patient’s behalf.

Costs of hospitalisation

Brazil has both a public and a private healthcare system.

Public Healthcare (SUS):  provides free healthcare to all, including foreigners. This covers all types of hospitalization in public hospitals, including for mental health care.

Private Healthcare: private hospitals and clinics in Brazil offer quicker and higher-quality care. However, if you need private healthcare, you will need insurance to cover part or full cost of treatment. If you do not have insurance and decide to go to a private hospital, you will be required to pay for the full cost. The FCDO cannot pay for medical fees.

SUS beds in Private Hospital: some private hospitals reserve a portion of their beds to SUS patients known as “leitos-SUS” (SUS beds), which are free of charge. Access to SUS beds is under discretion of the public health authorities and depend on local arrangements and availability. You cannot ask or demand to be transferred from a public hospital to a SUS bed in a private hospital.  

Emergency Care: In emergencies, the SAMU ambulance service will typically take the patient to a public hospital for immediate care. If you have a valid health insurance, a transfer can be arranged to a private hospital, but this depends on the insurance company and the situation.

Despite the public healthcare coverage for foreigners in Brazil, the UK Government’s Travel Advice advises you take out appropriate travel insurance before coming to Brazil. Read more about it here.

Guardianship

In Brazil, the process used to determine if someone lacks mental capacity to perform basics acts of civilian life is called interdiction (processo de interdição). This process can be started by family members or the public prosecution’s office (Ministério Público) in cases of:

• severe mental illness or disabilities,

• incapacity to express their will or understand certain situations,

• struggles with drug and alcohol addiction,

• people with reckless spending habits (prodigals).

During this process, the person will undergo psychological assessments and an interview by a specialist judge to determine their mental capacity. The judge will assess whether the person can make decisions about their own life.

If the judge decides the person is unable to make decisions, an interdiction is granted, and a guardian(curador) will be appointed. The guardian can be responsible for decisions about healthcare, finances and living arrangements.  

The guardian is usually an immediate family member, such as a parent, son/daughter or sibling. However, in some cases, a lawyer or another trusted person may be appointed. The judge usually appoints someone who lives in the same judicial district (comarca) as the patient, but in exceptional cases someone from outside of the area can be chosen, though a guardian cannot be someone resident in another country.

Note that compulsory hospitalisation and guardianship processes can experience setbacks if the patient does not have family members in Brazil, as it might be difficult for the family to express their wishes and have a proper say in the process. In such cases, the family should consider issuing a letter of attorney (procuração) to someone in Brazil to represent the wishes on their behalf.

Judicial processes in Brazil can be very bureaucratic and take a long time to reach conclusions. It can also be difficult to understand if you do not speak Portuguese. You should consider hiring a lawyer in cases with a judicial or legal angle. A list of English-speaking lawyers is available on GOV.UK.

Suicide

There are some lifelines/helplines for suicidal thoughts in Brazil, with the main one being Centro de Valorização da Vida (CVV), that can be dialled on 188. However, do not expect officers to speak English. In such cases, please refer to UK-based alternatives, such as Samaritans.

If someone is at risk of suicide, you should call the SAMU service on 192 and provide information on where the person is. Attempting suicide is not a crime in Brazil, but encouraging or inciting suicide is.

Return to the UK

Repatriation is possible in many cases and costs would normally be covered by travel insurance or personal funds. The Brazilian social services system and the Consulate/Embassy can help with some logistical issues but be advised that resources in Brazil are very constrained, so do not expect any financial assistance from the local authorities. Local travel can sometimes be covered by the Brazilian authorities on a case-to-case basis, but international travel cannot.

If the patient is already known to the mental health services in the UK, the consulate can facilitate communication between both medical teams.

Private repatriation companies are also available.

Other useful information

Foreign Commonwealth & Development Office guide (including links to UK NGOs/services)

UK health information:

• NHS: Find out how to access healthcare in Brazil

Brazilian organisations

• Gov.br information on CAPS services – types of CAPS services and how they operate.
• Centro de Valorização da Vida (Centre for Valorisation of Life) – suicide hotline and information organisation.
• Associação Brasileira de Alzheimer – information on Alzheimer disease for patients and families
• Associação Brasileira de Saúde Mental (Brazilian Association for Mental Health) – NGO that articulates users, doctors and training associations to improve mental health support in Brazil