Where to Seek Mental Health Help for Children and Adolescents in the Unified Health System (SUS)?

How does the public mental health system in Brazil work?

The Unified Health System (SUS) operates as a network so that each person receives the care they need. For children’s and adolescents’ mental health, the first place to seek help is Primary Health Care (APS) — through a Basic Health Unit (UBS) or the Family Health Strategy (ESF) — in your area of residence. These are where basic health services are offered; in other words, where professionals can listen to families, assess signs of emotional distress or behavioral changes, and guide them on the next steps.

When necessary, the APS can refer patients to specialized services, such as the Psychosocial Care Centers (CAPS), outpatient clinics, or polyclinics, where trained teams provide more specialized mental health care.

In urgent cases — such as suicide risk or severe crises — care can be sought directly at a CAPS, at Emergency Care Units (UPA), or by calling SAMU (192).

Is mental health care for children and adolescents the same across Brazil?

No. Brazil, given its continental size, has many regional differences. As a result, the availability of mental health services and the pathways to access them vary considerably from one city to another. In some municipalities, it is possible to go directly to a CAPS; in others, the entry point is exclusively Primary Care. It is therefore essential to confirm, in your own municipality, where to seek help first. Let’s learn a little more!

Where to start?

The first step, in most cases, is to seek Primary Health Care — that is, the Basic Health Unit or the Family Health Strategy in your area of residence. Primary Care units are present in virtually every part of Brazil and are typically distributed across neighborhoods and communities to make access easier for families. These are the places where caregivers can seek help when they have questions or concerns about the behavior, emotions, or development of children and adolescents in their lifes. At Primary Care units, a team of different health professionals — such as doctors, nurses, psychologists, and social workers — will be able to listen, assess the situation, and offer support. Sometimes care can be provided on the spot; in other cases, professionals will arrange a referral to specialized mental health services.

What specialized mental health services exist for children and adolescents?

In addition to APS units, which are usually the first port of call, there are specialized services for when mental health care needs to be more intensive. The main ones are the Psychosocial Care Centers (CAPS) — community-based, multidisciplinary health services that provide assistance to people who need psychosocial support, available in several types.

For example, Child and Youth Psychosocial Care Centers (CAPSij) are designed specifically for children and adolescents experiencing distress from serious and persistent mental health conditions who require more intensive care. These centers may have multidisciplinary teams — including psychiatrists, psychologists, occupational therapists, social workers, and nurses — and typically offer individual and group sessions, therapeutic activities, and family support. In some municipalities, it is possible to seek a CAPSij directly; in others, access is through a referral from the APS.

The presence and type of CAPS in each city depends on the population size and how the local health network is organized. In some larger municipalities, there may be a Child and Youth CAPS (CAPSij), dedicated exclusively to children and adolescents. In smaller cities, where the population is smaller, care is often provided at Type I or Type II CAPS, which serve all age groups in a single facility and are not exclusive to children and young people. There are also CAPS AD (Alcohol and Drugs), dedicated specifically to individuals — including adolescents — who face issues related to alcohol and other drug use.

In addition to CAPS, some municipalities offer resources that complement the mental health network. Multidisciplinary Mental Health Teams (EMAESMs) address more common and moderately severe mental health conditions, providing ongoing follow-up and family support. Some municipalities also have polyclinics, which function as medical specialty centers. These may include professionals focused on child and adolescent mental health, which facilitates integrated care when a child or adolescent needs follow-up from different specialists in the same setting.

In larger cities — especially those with University Hospitals — there may be specialized outpatient clinics in child and adolescent mental health, which can focus on specific conditions such as Attention Deficit Hyperactivity Disorder, Eating Disorders, anxiety, and depression.

For children and adolescents with developmental issues — such as global developmental delay or autism spectrum disorder — some cities have Specialized Intellectual Rehabilitation Centers. In addition to medical and psychological follow-up, these centers commonly offer multidisciplinary care involving speech therapists, physiotherapists, and occupational therapists. Access to these centers is generally through a referral from the APS or another point in the specialized network.

Although not available in every municipality, services such as those listed here form a network that aims to ensure each child or adolescent receives the most appropriate care for their situation, in ongoing dialogue with their families.

What if it is an emergency?

In crisis situations or mental health emergencies involving children and adolescents — such as suicide risk, severe agitation, or when there is a risk of the child or adolescent harming themselves or others — care must be immediate. In these cases, help can be sought directly at a CAPS (when available in the municipality), at Emergency Care Units (UPAs), or by calling SAMU (phone number 192), which provides emergency care and can arrange transport to the most appropriate health service.

Where can I find reliable information about the services available in my city?

The best way to find out how things work in your city is to contact the Municipal Health Secretariat or the Primary Care unit in your area of residence. These institutions can inform you which services are available, how to access them, and what care pathways are followed in the municipality.

Remember that SUS services and professionals are available to provide the necessary support, and that caring for the mental health of children and adolescents can be challenging — but Brazil’s public health system offers pathways so that no one has to face these situations without support.