New Mental Health Law in Portugal: What Really Changes?
Mental health is finally a legislative priority in Portugal. The new Mental Health Law (Law No. 35/2023), in effect since August 2023, replaces legislation that was over two decades old, aligning it with the evolution of society, human rights, and advances in psychological and psychiatric science.
But what really changes? And how does it impact those in need of mental health support, professionals, and families?
Why was a new law necessary?
For years, Portugal followed a disease-centered and institutional approach to mental health. The previous model, from 1998, focused heavily on hospitalization as an almost automatic response to crisis situations, with little emphasis on individual autonomy or prevention.
But the world has changed — and so has the way we view mental health. Updating the legal framework had become an urgent necessity.
What does the new Mental Health Law introduce?
This law is built on five key pillars:
- Rights and autonomy of individuals: For the first time, the law clearly enshrines the dignity, will, and informed consent of people with mental health conditions. Whenever possible, decisions must be shared between the person and healthcare professionals.
- End of the “dangerous patient” label: The assumption that a person with a mental illness is automatically a risk to society is eliminated. Criminal responsibility is no longer tied to a psychiatric diagnosis.
- Personalized treatment plans: Interventions must be tailored to the individual’s specific needs, rather than being dictated by institutional routines or structures.
- Strengthening community psychiatry: The law promotes the creation of community-based mental health teams to support individuals outside of hospital settings.
- Hospitalization as a last resort: Whenever possible, care should be provided in the least restrictive setting. Hospital admission is only considered when absolutely necessary.
What changes in practice?
- Involuntary hospitalization is now more restricted. It requires a thorough clinical assessment and validation by a judge.
- The treatment plan becomes mandatory and must be personalized.
- Mental health teams must coordinate with health centers, schools, and social services.
- The family has a clearer role and may participate, if the person wishes.
And the challenges?
Not everything is simple. The law is a major step forward, but turning it into reality requires human resources, specialized training, time, and a shift in mindsets.
- There are still a few fully operational community teams.
- Many professionals haven’t received training to implement the new procedures.
- There is a lack of investment in intermediate structures between hospitals and the community.
An opportunity
Despite the challenges, this is a unique opportunity to transform how we care for mental health in Portugal — shifting from a control-centered model to a care-centered one.
The law is written. Now it’s up to all of us — professionals, institutions, and civil society — to bring it to life.
MindPartner embraces this commitment by promoting accessible information, training professionals, and creating innovative solutions that put the person at the center of care.
Change starts with information. And it continues with commitment — ours, and everyone’s.