Why start with a general practitioner
Most people with symptoms of anxiety or depression do not need to go straight to a psychiatrist. The general practitioner is the correct entry point for most mental health presentations — especially for those who are experiencing symptoms for the first time or want to better understand what they are feeling.
The general practitioner can:
- Perform a structured mental health assessment — using validated tools such as PHQ-9 for depression and GAD-7 for anxiety
- Rule out organic causes — hypothyroidism, anemia, vitamin D deficiency, and other physical conditions that can cause or worsen mental health symptoms
- Provide guidance on initial management — including behavioral strategies, sleep hygiene, and physical activity as part of the care plan
- Refer to a psychologist or psychiatrist — when the presentation requires specialized follow-up
- Assess the need for medication — and refer to a psychiatrist when specialized pharmacological treatment is indicated
Who this service is for
This mental health consultation with a general practitioner is indicated for adults with:
- Anxiety — excessive worry, constant tension, difficulty relaxing, occasional panic attacks
- Depression — persistent sadness, loss of interest, fatigue, difficulty concentrating, changes in sleep and appetite
- Stress and burnout — work-related exhaustion, emotional overload, difficulty switching off
- Insomnia — difficulty falling asleep or staying asleep with an impact on daily functioning
- Physical symptoms with no clear organic cause — frequent headaches, muscle tension, digestive problems that may have an emotional basis
- Difficulty adjusting — moving to another city, job loss, relationship breakup, bereavement
- Expat stress — cultural adjustment, isolation, family separation, culture shock
- Those who want a first assessment before deciding whether they need a psychologist or psychiatrist
- Those who are already being followed by a psychologist or psychiatrist and need additional general clinical assessment
What this service is — and what it is not
This service is indicated for:
- Initial assessment of mental health symptoms
- Screening for mild to moderate anxiety and depression
- Guidance on initial management and self-care strategies
- Referral to a psychologist or psychiatrist when indicated
- Assessment of organic causes that may be contributing to symptoms
- Stable patients under specialist follow-up who need general clinical assessment
This service is not indicated for:
- Acute psychiatric crisis — if you are in crisis, use the resources at the top of this page
- Complex psychiatric disorders that require specialized psychiatric assessment — such as bipolar disorder, psychosis, or schizophrenia
- Psychotherapy — this is a medical assessment service, not psychotherapy. For psychological follow-up, a clinical psychologist is the most appropriate professional
- Psychiatric hospitalization — it cannot be initiated via telemedicine
Not sure whether you need a general practitioner, psychologist or psychiatrist? Start here. The doctor assesses your situation and guides you on the most appropriate next step for your case.
What is included in the consultation
Structured mental health assessment
The doctor uses validated screening tools — PHQ-9 for depression symptoms and GAD-7 for anxiety symptoms — and performs a complete clinical assessment including mental health history, previous episodes, prior treatments, current life situation and impact on daily functioning.
Assessment of organic causes
Physical conditions such as hypothyroidism, anemia, vitamin B12 or D deficiency, and others can cause or worsen mental health symptoms. The doctor assesses the need for tests to rule out these causes and orders them when indicated.
Initial management plan
Based on the assessment, the doctor provides guidance on initial management strategies — including sleep hygiene, physical activity, breathing and relaxation techniques, and behavioral adjustments that have scientific evidence for mild to moderate anxiety and depression.
Referral to a specialist — when indicated
When the presentation requires specialized psychological or psychiatric follow-up, the doctor refers with complete clinical documentation — to private psychologists or psychiatrists.
Safety assessment
Every mental health consultation includes a safety assessment — carried out sensitively as part of standard clinical care.
Mental health in Brazil — the context
Brazil has the highest prevalence of anxiety in the world and is the fifth country with the highest prevalence of depression, according to WHO data. At the same time, access to mental health care is one of the biggest challenges in the Brazilian health system:
- The SUS has approximately 6 psychologists per 100,000 inhabitants — far below the WHO recommended average
- Waiting times for a psychiatrist consultation through the SUS are months in most states
- Private psychologists and psychiatrists have high costs and long waiting lists in major urban centers
- Outside the capitals and major cities, access to specialized mental health care is even more limited
For those who need a first medical mental health assessment — without waiting months and without the cost of a specialist consultation — a teleconsultation with a general practitioner is the most accessible and fastest way to start.
Mental health for foreigners and expats in Brazil
For foreigners and expats living in Brazil, mental health challenges have specific characteristics that Brazilian professionals are not always prepared to address:
- Cultural shock and adjustment — difficulty adapting to Brazil can generate anxiety, isolation and a sense of loss of identity that have specific characteristics within the immigration context
- Family separation — being far from family and the usual support network is one of the main sources of stress in expat populations
- Language barrier — discussing mental health in a language that is not your own significantly increases the barrier to accessing care
- Uncertainty about the future — visa issues, employment contracts and staying in the country are sources of anxiety specific to this population
Our doctors provide care in English, Portuguese and Spanish — and have experience with international populations across multiple markets. If you prefer to discuss your mental health in English, this service is available to you.
