Guidance

Ecuador: mental health support for British nationals

Updated 27 September 2023

© Crown copyright 2023

This publication is licensed under the terms of the Open Government Licence v3.0 except where otherwise stated. To view this licence, visit nationalarchives.gov.uk/doc/open-government-licence/version/3 or write to the Information Policy Team, The National Archives, Kew, London TW9 4DU, or email: psi@nationalarchives.gov.uk.

Where we have identified any third party copyright information you will need to obtain permission from the copyright holders concerned.

This publication is available at https://www.gov.uk/government/publications/ecuador-mental-health-support-for-british-nationals/ecuador-mental-health-support-for-british-nationals

Our general help and advice

Whenever possible we will seek your consent before taking any action on your behalf.

If you are having mental health issues in Ecuador we can:

  • listen to you and help you look at your options
  • help you contact friends and family, with your permission
  • visit you in hospital
  • raise any concerns about your treatment or welfare for example, with hospital
  • help doctors in Ecuador contact UK doctors who know your medical history, with your prior consent
  • give you information about local pharmacies
  • offer help, if you choose to remain in Ecuador or elsewhere

We cannot:

  • give you advice on mental health issues
  • buy or supply medication
  • withhold or remove your passport
  • stop you from travelling abroad
  • require you to return to the UK
  • pay for you to return to the UK
  • pay for your food, accommodation or medical bills
  • get you better treatment in hospital or prison than is given to local people

Please see below for more detailed information on how to contact the British Embassy’s consular team for assistance.

What to do if you need help

In an emergency

In an emergency, you can:

  • call 911 for emergency services. You will be asked which service you require and you will need to ask for a doctor or ambulance, or
  • go directly to the nearest hospital emergency ward (“emergencias”)

Although ECU911 (the integrated security and emergency service) does have some English speaking call handlers, not all emergency services or doctors speak English. Consider using ECU 911 free smartphone application to register any medical issue and to ask for emergency assistance.

If necessary, ask a Spanish speaking person to help you with your call or to accompany you to the hospital.

Contact the British Embassy Quito at +593 2 3972 200 (24/7).

During your call or visit to the hospital, you should look to provide details of your previous medical background, which could include previous mental health episodes or diagnoses to assist with any assessment, and details of previous or current medication, to help determine further treatment.

After you are assessed by a general doctor, you may be referred onto another medical provider or service for further care. Depending on your financial situation, and whether or not you have medical insurance, you will have the option to choose private or public treatment.

Less urgent care

There is one national healthcare system in Ecuador (“Red Pública Integral de Salud y Red Complementaria”) which is managed by the Ministry of Public Health (Ministerio de Salud Pública - MSP). This involves access free of charge to public hospitals and medical centres, which are also supported by and provide complimentary services to the private health sector.

More information on how to access public health care in Ecuador.

In order to receive non-urgent treatment you either must be registered with the Ecuadorean Social Security Institute (IESS), or you can get an appointment from public healthcare (MSP) with a GP to then be redirected/referred to a specialist (“derivación/referencia”). For IESS´s appointments call 140.

Channels to get a medical appointment with MSP(except for emergencies), either by dialling 171 option 1 (toll free), or also by WhatsApp, Website, Facebook or ‘SaludEc’ telephone App.

IESS’s online appointment system (‘Servicio en línea’), by creating your username and password.

Public mental health services and resources in Ecuador are organised at 3 levels/tiers and are provided by a mental health community network (“red de salud mental comunitaria”):

  • tier 1: healthcare centres (A-B-C) that offer psychological, general or intensive care (“atención ambulatoria”). This level focuses on preventative and promotional healing
  • tier 2: basic and general hospitals offering emergency attention or outpatient and inpatient treatments, through a referral process from tier 1. This includes some mental health units (“Unidades de Salud Mental - USM”) for patients suffering from mental disorders
  • tier 3: specialised hospitals and centres for complex cases, including critical mental health, which require outpatient specialised attention or temporary inpatient treatment. These include specialised psychiatric treatment (“Hospital Especializado Julio Endara” and “Centro Ambulatorio Especializado San Lázaro”) and assessment mobile units, social care community and reinsertion follow up teams. There are drug and alcohol rehabilitation programmes available (“Centro de Especialización en el Tratamiento a personas con consumo problemático de Alcohol y otras Drogas” – CETAD)

Patients need to provide specific agreement for inpatient treatment by signing a consent document (“consentimiento informado”).

There is a strict adherence to the system between the above tiers, to ensure that all cases, except emergencies, start from tier 1 and also that once a critical case has been stabilised under tier 3, it goes back to tier 1 or 2 for follow up attention.

Priority attention is given to vulnerable groups (“grupos de atención prioritaria”), which may include: elderly, children and adolescent groups, pregnant women, detainees, foreign customers and violence-related cases. However, not all MSP’s Coordinaciones Zonales (CZ) will have in place healthcare services for all of the above groups (CZ9 for Quito/Pichincha does).

If you are registered with an Ecuadorean GP (“medico general” from IESS or MSP), you can make an appointment to see a doctor and discuss your condition. If necessary, they will prescribe medication or refer you to a Tier 2 specialist.

The outpatient services offered by state hospitals (Ministerio de Salud Pública – MSP) may vary from province to province.

In general, only in-person mental health public treatment is available. However, the MSP´s Mental Health Management has some additional support partners offering psycho-social virtual assistance, which can be of assistance in critical cases.

If you are visiting Ecuador and need to see a doctor if you are feeling unwell or need a repeat prescription, see the list of English-speaking private doctors in different areas of Ecuador.

Prescriptions: on holiday or recently moved to Ecuador

If you are on holiday or have recently moved to Ecuador and need a repeat or replacement prescription, you should contact a local GP or a hospital´s emergency warden in case of an emergency.

The referred doctor will be responsible for assessing your mental health condition and your medical prescription, which also may involve using a matching process to identify the generic medication available in Ecuador if your exact branded medication is not available.

A copy of your prescription can help doctors find the same or similar medication.

Involuntary hospitalisation

Involuntary hospitalisation may be used when a person presents a risk to themselves or others and refuses treatment or assessment.

If you have mental health needs and are hospitalised without your consent, the hospital may contact the British Embassy.

For more information on the assistance the British Embassy can offer you, check the following documents:

In Ecuador non-emergency involuntary admission to hospital has to be ordered by a judge. This includes cases involving adolescents and their parents´ who make a petition direct to a judge. However, a competent doctor has authorisation to involuntarily admit a person to hospital in an emergency without first obtaining the permission from a judge. A judge can be informed after the event to provide retrospective permission.

For critical cases where the patient cannot give consent for hospital admission, and also does not have any next of kin in Ecuador to sign the agreement form, a technical psychological report should be submitted to a competent judge to issue a judicial order. (“orden judicial/de amparo”). A follow up procedure will be arranged to identify where the patient will get social support after being discharged from hospital.

Once admitted to hospital, the patient is assigned a psychiatrist who will make decisions about assessment, treatment, discharge and ongoing care. An outpatient or ongoing care plan may be easier to arrange if you are a resident in Ecuador and with a local support network in place. However, public healthcare is offered to everyone regardless of immigration status. Visitors suffering from mental breakdown (“descompensación”) may be assisted with temporary inpatient treatment until being stabilised.

Costs of hospitalisation

The public healthcare system in Ecuador provides free emergency care and medical attention for everyone, including non-residents. In emergency cases you should go to the nearest A&E department or call 911 for the emergency services to arrange an ambulance service to take you.

The nearest hospital may be a private one and you can remain there until being stabilised. If you cannot afford the related medical costs, or you do not have any health/travel insurance, you can request to be transferred to an available public hospital once you have been stabilised.

Private hospitals require a credit card signed voucher for admission, or evidence that you have health insurance in place. However, please note that some hospitals in Ecuador may not have a direct agreement with your insurance company, so you may need to pay the costs upfront, or at the end of the treatment yourself and then arrange a refund afterwards from your insurance. If this is the case, ensure you get all relevant copies of your medical history and the original invoices.

Returning to the UK

You may wish to return to the UK at the end of any treatment received in Ecuador. When you are discharged from hospital, you should request a copy of your medical history, which is not automatically provided, only at a patient’s direct request.

If you want to return to the UK, ensure you obtain a “fit to travel” document signed by your doctor to present to the relevant airline. You may check with your airline beforehand since some airlines have their own form to complete and a separate medical clearance process.

You will normally be responsible for covering the costs of your return to the UK. If you are unable to afford these costs, your travel insurance company may cover repatriation costs. You can also discuss the options available to you with the British Embassy’s consular team – they can contact friends and family on your behalf to seek financial help.

Neither the Ecuadorean nor British authorities can fund repatriation. Hospitals might help with some practical arrangements. We can help you contact travel care services at UK airports for support upon arrival into the UK.

See medical repatriation companies in the UK

Contact the British Embassy for assistance

You can contact the British Embassy´s consular team at any time (+593 (0)2 3972 200) and they can determine how they can assist you. This includes helping you to contact your family or friends if that´s what you want and by signposting you to relevant support organisations. They can provide you with lists of English-speaking medical practitioners and local hospitals.

If you are travelling with a tour operator, you can ask for their support for a medical assessment or admission, depending on your mental health condition. If you wish, the tour operator may accompany you to the local hospital and contact the Embassy to request follow up consular assistance.

For more serious cases, and with your consent, this may include the engagement of the Ministry of Public Health’s Mental Health Management or District Coordination’s Mental Health Teams (CZ) to potentially facilitate a more straightforward assessment or guidance on available public treatment options.

If you want to return to the UK, the consular team can help you with this and will also provide you with information on the support available in the UK upon your return.

Other useful information

UK information

Ecuadorean organisations

Private and public Helplines (it is not guaranteed that an English speaking official will be available):

  • Ministerio de Salud Pública (MSP) – Helpline for mental health emotional support (“contención”), including for alcohol and drug issues, and crisis support for people with suicidal conduct: 171 option 6 (Monday to Friday from 0800 to 2000)

  • Red Cross in Pichincha for free virtual psychological and emotional assistance.

  • Anima EC - Instituto de Neurociencias in Guayaquil for psychological crisis support, including depression, anxiety and suicidal conduct. From Monday to Friday (0800 to 2000) by calling Free Helpline +593 (0)99 719 6911. ÁnimaEC Free Google Play App for 24/7 crisis emotional support. English speaking volunteers are available.

Disclaimer

The information contained in this note is intended for your general guidance only; it is not a substitute for obtaining your own medical and legal advice. Whilst all due care has been taken in compiling this information, accuracy cannot be guaranteed and the applicable law and procedures may occasionally change. For these reasons neither His Majesty’s Government nor any member of the British Embassy Consular staff can accept liability for any costs, damages or expenses which might be incurred as a result of the contents of this document.

The Foreign, Commonwealth and Development Office holds and uses data for purposes notified to the Information Commissioner under the Data Protection Act 2018 (which may be viewed at www.ico.org.uk). Such personal data may be disclosed to other UK Government Departments and public authorities.

Back to top