Spanish law foresees full access to the public health care system for all asylum seekers. Through this legal provision, they are entitled to the same level of health care as nationals and third-country nationals legally residing in Spain, including access to more specialised treatment for persons who have suffered torture, severe physical or psychological abuses or traumatising circumstances.
Since the 2012 reform of access to the Public Health System, which had limited the previously guaranteed universal access to health care, asylum seekers had been facing problems in receiving medical assistance, even though it is provided by law. In particular, some asylum seekers were denied medical assistance, because medical personnel was not acquainted with the “red card” (tarjeta roja) that applicants are provided with, or they did not know that asylum seekers were entitled to such right.
In September 2018, the Government approved a decree reinstating universal access to the Public Health System, thus covering irregular migrants as well.
During 2020 the Ministry of Health announced project of law establishing measures for the equality, the universality and the cohesion of the national health system, and launched a public consultation.
Although access to special treatment and the possibility to receive treatment from psychologists and psychiatrists is free and guaranteed, it should be highlighted that in Spain there are no specialised structures for victims of severe violations and abuses like the ones faced by asylum seekers escaping war, indiscriminate violence or torture. There are no specialised medical centres that exclusively and extensively treat these particular health problems.
Currently, there are different NGOs in charge of places for asylum seekers with mental health needs. For about 5 years, Accem, in collaboration with Arbeyal, a private company, managed the “Hevia Accem-Arbeyal” centre, specialised in disability and mental health. During 2018, it opened the Centre for the Reception and Integral Assistance to Persons with Mental Health Problems (Centro de Acogida y Atención Integral a Personas con Problemas de Salud Mental), and it’s dedicated to asylum seekers, beneficiaries of international protection and to migrants in a situation of vulnerability. The purpose of the residential centre is to promote the highest level of mental and physical well-being to people whose mental illness impedes their integration.
In addition, CEAR also manages places specialised in asylum seekers with mental conditions. La Merced Migraciones Foundation also provides reception places for young adult asylum seekers who need special assistance due to mental health-related conditions. Other NGOs have also developed specific resources to assist and accompany asylum seekers with mental health needs, such as Bayt al-Thaqafa (which is member of the Federación Red Acoge), Progestión, Provivienda and Pinardi. The NGO Valencia Accull (which is member of the Federación Red Acoge) has opened a reception facility in Valencia for single female asylum seekers/refugees. Information on organisations providing such services in Spain is not public.
During the COVID-19 pandemic, health professionals from the Lavapiés neighbourhood in Madrid asked for more interpreters in order to assist migrants.
In a report published in February 2021, Amnesty International underlines the increasing obstacles that undocumented migrants faced in accessing health services during the COVOID-19 pandemic. Such barriers are essentially due to the legislation that does not foresee the universal access to the National Health System, the insufficiency of adequate measures implemented by the Autonomous Communities, and the language barrier in order to access medical assistance by phone.
 Article 15 Asylum Regulation.
 Ministerio de Sanidad, ‘Consulta pública previa sobre el anteproyecto de ley de medidas para la equidad, universalidad y cohesión del sistema nacional de salud’, October 2020, available in Spanish at: https://bit.ly/3dmGUBG.
 Amnistía Internacional España, ‘La otra pandemia. Entre el abandono y el desmantelamiento: el derecho a la salud y la Atención Primaria en España’, February 2021, available in Spanish at: https://bit.ly/3qcdBnT.