Seeing a Psychologist at a State Hospital in Turkey: Appointments, Process and Expectations

How do you get a psychologist appointment at a state hospital in Turkey, and how do sessions work? Public options, realistic expectations and what to watch for.

You search the MHRS screen (Turkey's Central Physician Appointment System) for a clinic called "Psychology" but cannot find it on the list. A friend says, "There's a psychologist at the hospital near us, I went"; your neighbour adds, "It's impossible to find a psychologist in the state system, the queue is months long." Which is true? A psychologist service at a state hospital really does exist, but it is reached by a different route from a private counselling centre and works in a different way. In this article I explain step by step where the psychologist stands in the public system, how you can get an appointment, what psychologists working in hospitals do, what realistic expectations look like and the other options the public sector offers. My aim is to clarify the road map for readers who are thinking about their budget and researching public options.

Is There a Psychologist at a State Hospital? The Psychologist's Place in the Public System

Yes, psychologists and clinical psychologists work in many state hospitals, training and research hospitals, university hospitals and mental health hospitals. In the public system, however, psychologists usually work not as an independent outpatient clinic but together with the psychiatry department or outpatient clinic.

There is a logic to this arrangement: in hospitals, mental health applications are first assessed by a doctor; when the doctor considers it necessary, they refer the person to a psychologist for testing, assessment or psychotherapy. For child patients, this process runs through child and adolescent psychiatry outpatient clinics.

So the most common way of seeing a psychologist at a state hospital is to go to the psychiatric outpatient clinic first. In some hospitals a direct appointment with a psychologist may be possible, or the hospital's own internal booking arrangements may differ; the easiest way to find out is to call the hospital's information line.

How Do You Get an Appointment? MHRS and the Psychiatric Outpatient Route

The main ways of getting a psychiatry appointment at a state hospital are:

1. The MHRS website or mobile app: you can log in with your e-Devlet (e-Government) password and look for a suitable date by choosing the province, district, hospital and the "Mental Health and Diseases" clinic.
2. The ALO 182 line: the call line of the Central Physician Appointment System for those who want to book by phone.
3. Your family doctor: your family doctor can listen to your complaints, assess physical causes and refer you to the appropriate unit. This is a good first step, especially with symptoms such as sleep, appetite and fatigue, to rule out a physical cause.

On the day of the appointment, the psychiatrist assesses you. In this consultation, asking clearly, "I'd also like to see a psychologist; is that possible?" makes things easier. If the doctor considers it appropriate, they refer you to the hospital's psychologist. When the first session with the psychologist takes place after the referral depends on how busy the hospital is.

Because the doctor's consultation may be short, it is important to be able to summarise your difficulty in a few sentences. Many people get nervous in those few minutes and forget to say the most important thing; then, in the corridor, they think, "If only I'd mentioned that too." A small note in your pocket prevents that regret. It is also entirely ordinary to tell the doctor about any reservations you have about medication, or that you would like to prioritise therapy.

We explain in detail what being referred to a psychiatric outpatient clinic means, and how you can prepare for that consultation, in the article my psychologist referred me to a psychiatrist.

What Does a Psychologist at a State Hospital Do?

The workload of psychologists working in hospitals is very varied. Their main duties are:

• Psychological testing and assessment: intelligence tests, personality inventories, attention and memory assessments, developmental tests. These tests both contribute to the diagnostic process and provide the information doctors draw on in official processes such as medical board reports.
• Clinical interviews: assessment and support sessions with people referred by the doctor.
• Psychotherapy: depending on the hospital's resources and the psychologist's training, individual therapy may be provided. Because of the workload, these sessions may be shorter or less frequent than in the private sector.
• Group work and psychoeducation: some hospitals run group programmes on topics such as anxiety, depression, addiction or coping with chronic illness.
• Support for other departments: psychological support may be offered to patients and their relatives in oncology, dialysis, intensive care or chronic illness wards.
• Forensic and official assessments: they may work with doctors on assessments carried out at the request of a court or an institution.

This variety means that a significant part of hospital psychologists' time is devoted to tests and official processes. So regular, weekly therapy may not be possible in every hospital.

This picture does not mean that hospital psychologists work carelessly. On the contrary, they are often colleagues working at an intense pace, trying to reach a large number of people in limited time. Stating your expectation clearly at the start of the session, for example by saying "I'd like regular sessions to learn how to cope with my anxiety", makes it easier for the psychologist to explain clearly what they can and cannot offer you within the hospital's resources.

Realistic Expectations: Duration, Frequency and Waiting

If you are going to receive support from a psychologist at a state hospital, setting realistic expectations from the outset prevents disappointment.

Waiting time: in large cities and well-known hospitals, finding a psychiatry appointment can take several weeks. After a referral to the psychologist, there may be a further wait. Checking MHRS at different times to catch cancelled appointments, or trying smaller district hospitals, can sometimes shorten the wait.

Session length: sessions in state hospitals may be shorter than the standard fifty-minute sessions in the private sector.

Session frequency: instead of weekly sessions, sessions may be scheduled every two, three or four weeks.

Continuity: because of hospital psychologists' rotations, leave or changes of post, it may not always be possible to work with the same person for a long time.

Records: applications made at a hospital appear in your health records like any other consultation. These records are subject to confidentiality rules and cannot be seen by your employer or the people around you. Still, if you have concerns about this, finding out in advance what information can be shared with whom may put your mind at rest.

Say a civil servant in their forties, who has been losing sleep and feeling constantly tense since a restructuring at work, applies to a state hospital's psychiatric outpatient clinic. After the doctor's assessment, they are referred to a psychologist; the first session is given for three weeks later and sessions are scheduled once a month. If this civil servant learns breathing and sleep-routine exercises they can apply on their own between sessions and practises them regularly, they can gain a noticeable benefit even from infrequent sessions. But in situations that require more frequent and structured work, such as intense trauma or long-standing depression, this frequency may fall short.

The public system is an important route to mental health care; but expecting more from it than it was set up to do wears out both you and the people working there.

Other Options in the Public Sector

A state hospital's psychiatric outpatient clinic is not the only public option. Depending on your needs, the following institutions may also come into play:

• Training and research hospitals and university hospitals: these may have more comprehensive psychiatry and psychology units; some have specialist clinics and therapy programmes for particular problems.
• Mental health hospitals: in some large cities there are hospitals that serve only the mental health field. These hospitals also offer outpatient services.
• Community Mental Health Centres: these were set up mainly for the community-based follow-up and rehabilitation of people with long-term, severe mental illness. They are not the first port of call for general anxiety or relationship problems.
• AMATEM and ÇEMATEM: state centres for the treatment of alcohol and substance addiction, for adults and for children and adolescents respectively.
• Healthy Living Centres: in some districts, these centres may offer preventive health services and psychosocial support involving psychologists.
• Guidance and Research Centres (RAM) for children: institutions attached to the Ministry of National Education for educational assessment and special education processes.
• ALO 183: Turkey's social support hotline for advice and support on family, women, children and social services.

The services of these institutions can vary from region to region. You can ask your family doctor or the provincial health directorate's information line about the options where you live. In disaster areas or after a major crisis, psychosocial support programmes run jointly by public institutions and non-governmental organisations may also come into play. You may remember that such programmes were set up in many provinces after the 6 February 2023 earthquakes.

Getting More Out of Seeing a Psychologist at a State Hospital

In a system where sessions may be short and infrequent, going in prepared makes every minute more valuable.

1. Be clear about what you want. A clear statement such as "I can't sleep and I'm constantly anxious; I want to learn ways of coping with this" guides both the doctor and the psychologist.
2. Bring your symptoms in writing. Note in brief bullet points when it started, how it has developed and what challenges you most.
3. Work between sessions. If your psychologist suggests a record form, a relaxation exercise or a small behavioural experiment, practise it regularly. With infrequent sessions, most of the change happens between them.
4. Ask about group programmes. If your hospital runs group work on topics such as coping with anxiety, depression or grief, this can make a valuable contribution alongside individual sessions.
5. Do not miss your appointments. In a busy system, finding a replacement for a missed appointment can take a long time. If you cannot come, cancelling in advance also frees up a place for someone else in the queue.
6. Plan the next appointment before you leave. Asking for the next date before the session ends prevents the process from stalling.

If you are curious about how a first session goes, whether in the public or private sector, you can read the article on the first therapy session for a general framework.

Public or Private? Things to Consider When Deciding

Public and private options are not rivals; many people use both together. For example, continuing psychiatric follow-up at a state hospital while doing regular therapy with a private practitioner is a common path.

The following questions may help you decide:

• How often do I need sessions? If your symptoms are intense and weekly, structured work is needed, the frequency the public sector can offer may fall short.
• What does my budget allow? When thinking about the cost of private options, you also need to take the total length and the frequency of sessions into account. We cover this topic in detail in the article on psychologist session fees.
• Do I need a particular therapeutic approach? If, for example, you are looking for a practitioner with specialist training for obsessive-compulsive symptoms, post-traumatic difficulties or couple problems, it may not always be possible to find this in the public sector.
• How important is continuity to me? If you want to work with the same practitioner for a long time, this may be hard to secure in the public system.

The city you live in also affects this decision. In many provinces and districts in Anatolia, hospital appointments may be easier to access than in large cities; on the other hand, the number of therapists specialising in a particular area may be limited. In such situations, mixed solutions are also possible, such as continuing your doctor's follow-up at the local state hospital while working online with a specially trained practitioner you need. What matters is building a support network that suits your situation, rather than expecting a single institution to meet every need.

You can read how regular individual work with adults is planned on the individual therapy page.

When Should You Seek Help Without Waiting?

In a system where appointment queues can be long, knowing the situations in which you must not wait is vitally important.

• If thoughts of harming yourself or ending your life are intensifying,
• If someone close to you seems to have lost touch with reality, for example saying they hear voices others do not hear or acting on intense suspicions,
• If someone has not slept at all for days and is showing extremely restless and uncontrolled behaviour,
• If a serious situation has developed linked to alcohol or substance use,

do not wait for an appointment. Call 112 (emergency services) or go to the emergency department of the nearest hospital. Emergency departments can call in a psychiatrist for an assessment when necessary. At such a moment, not leaving your loved one alone, speaking to them in a calm voice and removing dangerous objects from the surroundings are the most important things you can do until help arrives.

Frequently Asked Questions

Can I book directly with a psychologist at a state hospital?

In most hospitals the route to a psychologist goes through the psychiatric outpatient clinic; a referral is made after the doctor's assessment. Some hospitals may have different arrangements. You can find out which route is followed by calling the information line of the hospital you plan to go to.

Do sessions with a psychologist at a state hospital cost money?

For people covered by general health insurance, psychiatry and psychology services at state hospitals are largely covered by that insurance. A contribution fee may be charged for some visits. The best thing is to check the current practice with your hospital.

Where should I go at a state hospital for my child?

Children and adolescents are seen at child and adolescent mental health outpatient clinics. Because waiting times at these clinics can be long, it is wise to book early. For school-related educational assessments, you can apply to a RAM.

Can I see the same psychologist regularly at the hospital?

This depends on how the hospital operates and on the psychologist's workload. In some hospitals, regular sessions with the same psychologist can be scheduled at set intervals; in others, sessions remain more assessment-focused. Asking about this openly in the first session clarifies your expectations.

• #public mental health services
• #MHRS
• #psychiatric outpatient clinic
• #psychological support

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Eda Erkan Alapala

Klinik Psikolog. İstanbul Kent Üniversitesi Klinik Psikoloji Tezli Yüksek Lisans mezunu; bilişsel davranışçı terapi, çocuk merkezli oyun terapisi ve çocuk-ergen psikoterapisi alanlarında eğitimlerini tamamlamıştır.

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