Portugal's Ombudsman Presses for Mental Health Care in Youth Detention, Child Care Units and Prisons, as a Promised Unit Stays Shut

Five of the six young adults still living in Portugal's specialist care units for children and young people had a serious mental illness when the Ombudsman's inspectors visited, the Provedora de Justiça (Ombudsman), Luísa Neto, has said. In a note for World Mental Health Day, she warns that the State is still not providing enough mental health care for people who cannot easily seek help themselves: children in care, young offenders and prisoners.

The note, published on the Ombudsman's website and picked up by Lusa on Monday, draws on the work of the Mecanismo Nacional de Prevenção (National Preventive Mechanism, MNP). This is the Ombudsman's inspection team. It visits prisons, youth detention centres, mental health units and other places where people are deprived of their liberty.

Specialist care units are filling a clinical gap

Children taken into care under Portugal's child protection system can be placed in five specialist residential units, in Lisbon, Montemor-o-Novo, Coimbra, Porto and Gondomar. These units take children whose educational or therapeutic needs are intensive. In a thematic report in November 2025, the MNP said the units then housed 61 young people aged 12 to 25, most of them female. That is about 1 percent of the 5,605 children and young people in care in Portugal.

Ten of the 61 had what the Ombudsman calls "very complex" mental health conditions. Of the six who had turned 18 and were still in the units, five had a serious mental illness. "These structures cannot replace specialised and lasting clinical responses," the note says. It calls for closer coordination between the health service and Social Security, so that young people keep their care and support as they move into adulthood.

The report made 19 recommendations. It found that the units' weaknesses came mostly from failures elsewhere in the system, not from their staff. Among them were very different profiles placed together and difficulty getting young people admitted to hospital. Decreto-Lei n.º 39/2025, which reorganised care homes, created specific units for children with profound disabilities, serious chronic illness or psychiatric disorders. The Ombudsman notes that the statute of the special care units (unidades especiais de acolhimento) has still not been regulated. Meanwhile, she adds, a lack of suitable social services still leads courts to order children into residential placements.

A unit for young offenders that has not opened

In the youth detention centres (centros educativos), the MNP has warned since 2019 that therapeutic care is lacking. In 2022, half of the young people held were receiving mental health follow-up, and more than 80 percent in some centres. The MNP recommended a dedicated unit, known as the "Casa Amarela" ("Yellow House"), next to the Bela Vista youth detention centre. It was still not operating in 2024. The project has since been redefined to stabilise young people temporarily in a crisis, and it is still waiting to open.

Prisons and people found not responsible for their crimes

In prisons, the MNP keeps finding people with serious mental health problems, as well as self-harm and suicide attempts, made worse by overcrowding. The same inspectors reported last month on a prison guard who escaped a case because time ran out. In 2025 the MNP also began a thematic report on the conditions of people declared not criminally responsible (inimputáveis) and held under court-ordered internment. It is due by the end of 2026.

The gaps reach beyond the justice system. In September, about 300 psychiatric patients were still on hospital wards because there was nowhere to discharge them. Anyone who believes a public body has failed them, or a relative in its care, can turn to the Ombudsman. Our guide to complaining to the Provedor de Justiça explains how.