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How To Get Affordable State Sponsored Therapy in Puerto Rico

(Lee este artículo en español)

If you’re looking for free or low-cost counseling, you might think your only options are counselors in private practice. However, publicly-funded mental health services are available throughout the United States, including Puerto Rico, and may be an option for you. Many publicly-funded programs offer affordable counseling or therapy to people who qualify for their services.

While publicly-funded programs are not for everyone, they’re often a great place to start. Intake specialists at community mental health clinics can help you learn whether you qualify for their services. And even if you don’t qualify, they can often refer you to other low-cost local programs that can serve you.

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When Should You Go to a State Mental Health Program?

While few private mental health providers are able to immediately serve people in crisis, Puerto Rico’s public mental health program has a crisis response system that helps people get mental health care quickly in an emergency. This usually makes the public system the best option if you’re having a mental health crisis and need help right away. The people who answer Puerto Rico’s crisis lines can provide caring attention and support as they help you determine the best response to a crisis, whether it’s inpatient treatment or an appointment with a counselor.

In addition to affordable therapy, publicly-funded outpatient mental health programs in Puerto Rico often offer specialized and intensive services that aren’t available anywhere else or that are hard to find in private clinics. Consider going to a publicly-funded provider if you need intensive treatment or can’t access mental health care in the private sector due to your diagnosis or financial situation.

Who Is Eligible for Public Mental Health Services in Puerto Rico?

Puerto Rico’s mental health department, La Administración de Servicios de Salud Mental y Contra la Adicción (ASSMCA), authorizes private programs to provide publicly-funded outpatient mental health services. Since these providers are privately operated, they have some leeway to set their own eligibility requirements. This means you will need to ask each provider what range of issues they treat and who is eligible for their services.

Programs in the Puerto Rico public network serve a wide range of clients. These include clients with mild to moderate mental health needs as well as clients with severe mental illness. For example, INSPIRA, which operates publicly-funded outpatient mental health clinics across Puerto Rico, lists “autoestima,” “agotamiento emocional,” and “estrés” (self-esteem, emotional exhaustion, and stress) alongside “depresión,” “ansiedad,” and “traumas” (depression, anxiety, and trauma) as issues they treat in their clinics.

Many outpatient mental health providers in Puerto Rico deliver mental health services in the context of integrated primary care. For example, Neomed Center and HealthproMed are integrated clinics that are licensed by ASSMCA to provide outpatient mental health services alongside primary care and other medical services. Integrated clinics like these tend not to have restrictive eligibility criteria.

Ultimately, whether you are eligible to get mental health services at a publicly-funded program in Puerto Rico depends on each program’s capacity and criteria. Financial aid policies vary among providers as well, but most programs in the public network accept both public and private insurance and offer sliding scales or reduced fees to those who qualify.

The best way to find out if you’re eligible for services at a publicly-funded provider in Puerto Rico is to call that provider directly. By talking to them, you can find out what kind of services they offer, whether you might be eligible, what insurance they accept, and whether financial aid is available.

How Can You Find Out More About Local Programs in Puerto Rico?

The best way to find out about local mental health resources in Puerto Rico is to call Línea PAS, the country’s 24/7 mental health crisis and information line. Línea PAS provides crisis counseling, evaluation, and referral services. You can reach Línea PAS by dialing 1-800-981-0023. You can also find a live chat feature and more information on their website.

Public mental health services in Puerto Rico are managed on the state level by  La Administración de Servicios de Salud Mental y Contra la Adicción (ASSMCA). For general information about the Puerto Rico mental health system, you can call ASSMCA at (787) 763-7575.

You can also contact your local program directly. Below, you can find numbers for ASSMCA-licensed outpatient mental health clinics for adults in Puerto Rico. We compiled this list using information from ASSMCA’S list of licensed mental health facilities and individual clinic websites.

North Region Clinics

ARECIBO – Clínicas Ambulatorias de Salud Mental:

BARCELONETA – Clínicas Ambulatorias de Salud Mental:

CAMUY – Clínicas Ambulatorias de Salud Mental:

HATILLO – Clínicas Ambulatorias de Salud Mental:

MANATÍ – Clínicas Ambulatorias de Salud Mental:

Metro Region Clinics

BAYAMÓN – Clínicas Ambulatorias de Salud Mental:

CAROLINA – Clínicas Ambulatorias de Salud Mental:

GUAYNABO – Clínicas Ambulatorias de Salud Mental:

SAN JUAN – Clínicas Ambulatorias de Salud Mental:

TOA BAJA – Clínicas Ambulatorias de Salud Mental:

TRUJILLO ALTO – Clínicas Ambulatorias de Salud Mental:

East Region Clinics

CAGUAS – Clínicas Ambulatorias de Salud Mental:

CANÓVANAS – Clínicas Ambulatorias de Salud Mental:

  • Centro de Orentación y Ayuda Psiquiátrica, Inc. (Canóvanas): (787) 256-0273 o (787) 648-4863

CEIBA – Clínicas Ambulatorias de Salud Mental:

CULEBRA – Clínicas Ambulatorias de Salud Mental:

GURABO – Clínicas Ambulatorias de Salud Mental:

HUMACAO – Clínicas Ambulatorias de Salud Mental:

JUNCOS – Clínicas Ambulatorias de Salud Mental:

LAS PIEDRAS – Clínicas Ambulatorias de Salud Mental:

  • COSSMA (Las Piedras): (787) 739-8182 x1600
  • NOR Community Mental Health (Las Piedras): (787) 716-0050

LOÍZA – Clínicas Ambulatorias de Salud Mental:

LUQUILLO – Clínicas Ambulatorias de Salud Mental:

NAGUABO – Clínicas Ambulatorias de Salud Mental:

  • COSSMA (Naguabo): (787) 739-8182 x1800

RÍO GRANDE – Clínicas Ambulatorias de Salud Mental:

SAN LORENZO – Clínicas Ambulatorias de Salud Mental:

VIEQUES – Clínicas Ambulatorias de Salud Mental:

YABUCOA – Clínicas Ambulatorias de Salud Mental:

  • COSSMA (Yabucoa): (787) 739-8182 x1400

Central Region Clinics

AGUAS BUENAS – Clínicas Ambulatorias de Salud Mental:

AIBONITO – Clínicas Ambulatorias de Salud Mental:

CAYEY – Clínicas Ambulatorias de Salud Mental:

CIDRA – Clínicas Ambulatorias de Salud Mental:

LARES – Clínicas Ambulatorias de Salud Mental:

NARANJITO – Clínicas Ambulatorias de Salud Mental:

OROCOVIS – Clínicas Ambulatorias de Salud Mental:

UTUADO – Clínicas Ambulatorias de Salud Mental:

South Region Clinics

COAMO – Clínicas Ambulatorias de Salud Mental:

GUAYAMA – Clínicas Ambulatorias de Salud Mental:

PONCE – Clínicas Ambulatorias de Salud Mental:

SANTA ISABEL – Clínicas Ambulatorias de Salud Mental:

YAUCO – Clínicas Ambulatorias de Salud Mental:

West Region Clinics

AGUADA – Clínicas Ambulatorias de Salud Mental:

AGUADILLA – Clínicas Ambulatorias de Salud Mental:

CABO ROJO – Clínicas Ambulatorias de Salud Mental:

GUÁNICA – Clínicas Ambulatorias de Salud Mental:

ISABELA – Clínicas Ambulatorias de Salud Mental:

LAJAS – Clínicas Ambulatorias de Salud Mental:

LAS MARÍAS – Clínicas Ambulatorias de Salud Mental:

MARICAO – Clínicas Ambulatorias de Salud Mental:

MAYAGÜEZ – Clínicas Ambulatorias de Salud Mental:

MOCA – Clínicas Ambulatorias de Salud Mental:

RINCÓN – Clínicas Ambulatorias de Salud Mental:

SAN SEBASTIÁN – Clínicas Ambulatorias de Salud Mental:

Federally Qualified Health Centers

Federally qualified health centers (FQHCs) are another option for public mental health care in Puerto Rico. These federally-funded programs provide medical and mental health services to people in underserved communities. Their goal is to deliver high-quality coordinated care to people with complex needs and to link behavioral healthcare with primary medical care. Each FQHC accepts Medicaid and Medicare and offers sliding-scale fees to people without insurance. You can search for FQHCs using the online search tool on the U.S. Health Resources and Services Administration website.

How Does Puerto Rico's Public Mental Health System Work?

While Puerto RIco is treated like a state in many ways—it is more or less categorized as a state by Medicaid and other United States public programs it participates in—it receives less funding than other states in the U.S. and is not recognized officially by the federal government as a state.

Puerto Rico has its own government, but any laws it passes are subordinate to federal U.S. laws (even though it has no voting representatives in Congress). This affects how public programs operate in Puerto Rico.

For example, despite serving a large portion (almost half) of Puerto Rico’s population, Medicaid is limited by U.S. federal policies that place a stricter cap on Puerto Rico’s Medicaid funds than on any state’s. Yet while they receive less funding, Puerto Rico’s public programs must still meet the same federal requirements as public programs in better-funded states.

Despite these limitations, Puerto Rico’s publicly-funded mental health system operates the same way as many state mental health systems in the rest of the U.S. The Puerto Rican mental health department, ASSMCA, licenses private facilities to deliver publicly-funded mental health services. These programs are financed by Medicaid as well as by additional public and grant funds.

Puerto Rico’s mental health system began in the 1800s with the establishment of psychiatric hospitals on the island. It shifted from institutional to community-based care during the deinstitutionalization movement of the 1950s and 1960s. Many of its first community mental health centers were built with funds created by the 1963 Community Mental Health Centers Act.

Puerto Rico’s system changed significantly with the creation of ASSMCA by Act No. 67 in 1993. When Act No. 408, the Mental Health Code of Puerto Rico, was passed in 2000, it established basic standards for the public mental health system and a Bill of Rights for those who receive mental health services in Puerto Rico.

Puerto Rico’s public services were majorly impacted by Hurricanes Irma and María in 2017. Its mental health system is no exception. Many clinics closed or had to reduce service capacity in the wake of damage caused by the hurricanes and subsequent natural disasters.

However, despite getting limited aid from the federal government, Puerto Rico is recovering and has repaired and reopened many of its healthcare facilities. Its mental health system continues to offer the full range of services and operates hundreds of hospitals and clinics across the country. This is more important than ever given the significant mental health impacts of these natural disasters. So, if you need care in Puerto Rico, please don’t hesitate—that care is there for you. Reach out and call Línea PAS or your local clinic to get the care you need.

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