A complete guide to accessing therapy, navigating the Italian mental health system, and finding multilingual support in Milan, Rome, Florence, and across Italy.
If you are an expat living in Italy, understanding how to access mental health services in Italy for expats can feel overwhelming – especially when bureaucracy, language barriers, and an unfamiliar healthcare system stand between you and the support you need. You are not alone: Italy is home to over 5.56 million foreign residents in Italy (ISTAT, 1 January 2026), and nearly half of all globally mobile workers report experiencing loneliness in their host country (Cigna Healthcare International, 2025).
Therapsy is a multilingual psychotherapy service in Italy that connects expats with licensed therapists who speak their mother tongue. With 50+ therapists, 14 languages, and sessions available online and in-person across 24 Italian cities, Therapsy was created specifically to bridge the gap between expats and quality mental health care.
In July 2025, Italy launched its new National Mental Health Plan 2025-2030 – a landmark reform that aims to reshape how the country delivers psychological services. This guide explains what the Plan includes, how expats can access mental health care through the public and private systems, how the Bonus Psicologo works for foreigners, and why multilingual therapy can make a real difference in your recovery.
Why is Italy reforming its mental health care system?
Italy’s mental health system is undergoing a major transformation because demand for psychological services has far outpaced the capacity of the public system. In 2025, 28% of the Italian population reported suffering from mental health disorders – an increase of six percentage points compared to 2022 – leading Health Minister Orazio Schillaci to describe the situation as a “true silent emergency.”
The numbers behind this crisis are striking. Depression rates in Italy grew from 5.5% before the COVID-19 pandemic to 17.3% in 2020 (Phenomena Journal, 2026). Over 700,000 young people under 25 now live with anxiety or depression, and the OECD confirms that these disorders among under-20s grew by 20% between 2018 and 2022. Yet Italy allocates only 3.3% of its total healthcare budget to mental health – well below the European average of 5% (WHO Euro Health Observatory, 2025).
For expats, the situation is even more challenging. The Italian public system has limited capacity and almost no provisions for non-Italian speakers. Long waiting lists, bureaucratic hurdles, and language barriers make it extremely difficult for foreign residents to access timely psychological support through the Servizio Sanitario Nazionale (SSN). This is precisely why services like Therapsy exist – to fill the gap between what the public system offers and what expats actually need.
The new Plan acknowledges these structural problems and sets out a roadmap for change. But understanding what it actually means for you as an expat requires looking at the details.
What does Italy’s National Mental Health Plan 2025-2030 include?
Italy’s National Mental Health Plan 2025-2030 is a comprehensive reform framework that will reshape mental health services in Italy for expats and residents. It is built around six strategic areas designed to modernize the country’s approach to psychological care. It was approved by the State-Regions Conference in July 2025 and represents the first major overhaul of Italy’s mental health policy in over a decade.
The six priority areas are:
1. Promotion, prevention, and care
The Plan introduces primary care psychologists within community health centres (Case della Comunita), who will provide free, non-medicalized support for mild to moderate mental health issues. The aim is to make a psychologist available directly in the local community centre. The Plan also promotes emotional literacy programs in schools.
2. Childhood and adolescence
Dedicated transition teams will support young people moving from pediatric to adult mental health services. Given that over 700,000 under-25s in Italy struggle with anxiety and depression (OECD, 2025), this is a critical area of investment.
3. Justice and security measures
The Plan strengthens mental health services within the justice system, with a focus on rehabilitation and reintegration.
4. Risk management and clinical safety
New protocols for clinical risk management in psychiatric settings aim to improve patient safety and reduce adverse events.
5. Social and healthcare integration
A “Health Budget” model promotes coordination between mental health services, social services, and community support networks. Case managers will coordinate personalized care pathways for people with severe and complex conditions.
6. Training, research, and digital innovation
Telehealth and artificial intelligence will complement traditional service delivery. The Plan also calls for specialized training programs – including cultural competence training for healthcare professionals working with diverse populations.
What does this mean in practice? The introduction of community-based psychologists is the most relevant change for residents, including expats. However, it is important to set realistic expectations: these services will be delivered in Italian, and implementation will vary by region. Therapsy’s team monitors these developments closely and can help expats understand which new services are accessible to them.
How can expats access mental health services in Italy?
Expats who are registered with the national health service (SSN) can use its mental health services on the same terms as Italian citizens. EU, EEA, and Swiss citizens enjoy simplified access through European coordination agreements. In practice, however, accessing mental health services in Italy for expats involves navigating a complex and often frustrating system.
The public pathway: SSN and Centro di Salute Mentale (CSM)
Public mental health care in Italy is organised by the Department of Mental Health (Dipartimento di Salute Mentale) of each local health authority or hospital trust. The first point of contact is the Centro di Salute Mentale (CSM), a community centre staffed, as the Ministry of Health describes it, by a team of at least a psychiatrist, a psychologist, a social worker and a nurse. In Lombardy the equivalent centre is called CPS (Centro Psico-Sociale).
How to reach a public mental health centre, step by step:
- Check your position with the national health service (SSN). Non-EU citizens with a residence permit register with the SSN, in some cases compulsorily and in others voluntarily: the Ministry of Health’s page links to both procedures. If you are insured in another EU country and are in Italy temporarily, your European Health Insurance Card covers medically necessary care, subject to a co-payment. If you are an EU citizen living in Italy for more than three months, ask your local health authority about registering.
- Find the centre for your address. Centres usually serve a catchment area, so you go to the one that covers where you live. The website of your local health authority lists them.
- Contact the centre directly. The national rules on essential levels of care define community mental health care as direct-access, so you can usually contact the centre yourself. Some centres prefer a referral from your family doctor, so it is worth calling first.
- Expect a first interview, then an appointment. In Bologna, for example, the local health authority explains that the first contact is an interview with a nurse, followed by an appointment for the specialist visit.
Three things to know before you go. Whether you pay a co-payment (ticket) depends on the Region and on the kind of care. Do not count on finding staff who work in English: ask when you call. And if you are not registered with the SSN, emergency departments still treat you, but you may be charged for the care.
What to do in a mental health emergency in Italy
If you or someone near you is in immediate danger, call 112, the single European emergency number: the call is free, as the Ministry of Health explains. The ambulance number 118 is also still active.
You can also go to the emergency department (Pronto Soccorso) of the nearest hospital. Where the hospital has a psychiatric unit, called SPDC (Servizio Psichiatrico di Diagnosi e Cura), the emergency doctors can involve it. People who are not registered with the national health service are also treated in an emergency, though they may be charged for the care.
For a health problem that cannot wait for your own doctor but is not an emergency, some regions have the free number 116117, answered in Italian and in English. It is not an emergency number. The Ministry of Health publishes the list of the areas where it is active.
A private therapy service, Therapsy included, is not an emergency service: we reply to requests within 12 hours, which is not fast enough in a crisis.
The private pathway
Most expats in Italy end up seeking private mental health care – making private providers the most common pathway to mental health services in Italy for expats – either because of the public system’s limitations or because they need therapy in a language other than Italian. Private therapy sessions typically cost between 60 and 120 euros per session, depending on the therapist’s experience and location.
At Therapsy, individual therapy starts from 70 euros per session and couples therapy from 100 euros per session. Every journey begins with a free personal matching on WhatsApp, where the Clinical Director or her onboarding assistant evaluates your needs and chooses the right therapist for you, followed by a free assessment call with that therapist. Both steps are free. This human-matched approach is one of Therapsy’s key differentiators – no chatbots, no algorithms, just a real conversation with an experienced psychotherapist.
International health insurance
If you have international health insurance (such as Cigna, Allianz, or other global providers), many policies cover private psychotherapy sessions. Some Therapsy clients have been reimbursed by Cigna and Therapsy works with several EAP (Employee Assistance Program) providers, so your sessions may be partially or fully covered.
What is the Bonus Psicologo and can expats use it?
The Bonus Psicologo is Italy’s government-funded program that provides a financial contribution toward private psychotherapy costs, and yes, expats can apply for it. The Bonus Psicologo has been a permanent measure since the 2023 Budget Law (Law 197/2022). Its budget is small: press reports put the 2026 funding at about 8.5 million euros.
How much can you receive?
The amount depends on your ISEE (Indicatore della Situazione Economica Equivalente), Italy’s standardized income and assets assessment:
- ISEE under 15,000 euros: up to 1,500 euros (approximately 30 sessions)
- ISEE between 15,000 and 30,000 euros: up to 1,000 euros (approximately 20 sessions)
- ISEE between 30,000 and 50,000 euros: up to 500 euros (approximately 10 sessions)
The contribution covers up to 50 euros per session and INPS pays it directly to the psychotherapist, who must be on the list of psychotherapists taking part in the scheme. In the 2025 round, beneficiaries had to attend a first session within 60 days of the ranking being published and use their code within 270 days.
Can expats and foreigners apply?
Yes. The only two requirements are residency in Italy and a valid ISEE not exceeding 50,000 euros. There are no citizenship requirements and no minimum residency duration. If you are a foreign national registered as a resident in Italy and have a valid ISEE, you can apply (INPS).
How to apply
Applications are submitted online through the INPS portal using SPID, CIE, or CNS digital credentials. There is one application window a year. In 2025 it ran from 15 September to 14 November. At the end of October 2026, INPS had not yet published the dates for 2026: they will appear on the INPS service page for the Bonus Psicologo.
Important caveat: Demand vastly exceeds funding. In recent years, only a small fraction of applicants received the bonus. Apply as early as possible when the window opens.
International students can apply only if they are registered as residents in Italy and have a valid ISEE. Students who keep their residence abroad do not qualify. Therapsy does not accept the Bonus Psicologo: it can be used only with the psychotherapists on the INPS list.
Why do expats in Italy face unique mental health challenges?
Living abroad is one of the most psychologically demanding transitions a person can experience, and expats in Italy face a specific set of mental health challenges that the general population does not encounter. Research from Cigna Healthcare International shows that 48% of globally mobile workers report feeling lonely – lacking meaningful companionship in their new city or country.
Culture shock and adjustment difficulties
In Italy, adapting to a new culture is compounded by the pace of Italian bureaucracy – from the questura to the Agenzia delle Entrate – which can feel disorienting and isolating.
Language-related stress
Even expats who speak conversational Italian often struggle to express emotions, describe symptoms, or process trauma in a second language. Research published in the Journal of Multilingual and Multicultural Development shows that emotional processing is significantly deeper in one’s first language (Dewaele & Costa, 2013. This means that even if you can order a coffee in Italian, you may need therapy in English, French, German, or your mother tongue to truly heal.
Expat-specific triggers
Common psychological issues among expats in Italy include relocation anxiety, homesickness, identity loss, relationship strain (especially in intercultural couples), career disruption, and a persistent feeling of “not belonging.” The data backs this up: 40% of expats return to their home country within three years, with loneliness and mental health difficulties cited as primary reasons.
The “silent suffering” problem
Many expats delay seeking help because they don’t know where to start, can’t find a therapist who speaks their language, or assume that Italy’s mental health system won’t serve them. This is where Therapsy steps in. With therapists available in 14 languages across 24 Italian cities, Therapsy was designed to eliminate the barriers that keep expats from getting the support they need.
What are the barriers to mental health care for foreigners in Italy?
The biggest barrier to accessing mental health services in Italy for expats is language. Only 5% of Italy’s approximately 130,000 psychologists work in the public system (Expatica, 2025), and the vast majority practice exclusively in Italian. Finding a licensed, experienced therapist who speaks your language – and understands the cultural context of your experience – is the central challenge when seeking mental health services in Italy for expats.
Bureaucratic complexity
Navigating the Italian healthcare system requires a codice fiscale, a tessera sanitaria, registration with a local ASL (Azienda Sanitaria Locale), and a medico di base. For new arrivals, this process can take weeks or even months. Many expats – 44% of Therapsy’s clients lack an Italian fiscal code – are not yet integrated into the public system.
Regional disparities
Mental health service availability varies dramatically by region. If you live in Milan or Bologna, you’ll have more options than if you’re in a smaller city in Puglia or Sardinia. Therapsy addresses this directly by offering online therapy to clients across all of Italy – and internationally.
Cultural stigma
In some communities, mental health still carries significant stigma. Expats from cultures where therapy is not normalized may hesitate to seek help. The new National Mental Health Plan acknowledges this by investing in promotion and prevention – but changing cultural attitudes takes time.
Cost concerns
Private therapy in Italy typically costs between 60 and 120 euros per session, which can be a barrier for students and early-career professionals. However, between the Bonus Psicologo (which Therapsy does not accept), international insurance coverage, and services like Therapsy that offer transparent pricing starting from 70 euros per session, there are more options than many expats realize.
How does multilingual therapy improve mental health outcomes?
Multilingual therapy leads to better outcomes because emotional expression and processing are fundamentally tied to language. Research consistently shows that people experience and express emotions differently depending on which language they’re using, and that therapeutic breakthroughs are more likely to occur in a client’s dominant language.
A 2020 study by Dewaele and Costa found that bilingual individuals report feeling “different” when switching languages, and that their emotional memories are more vividly accessible in their first language. In a therapeutic context, this means that a Dutch expat in Rome who speaks functional Italian may still be unable to access and process a childhood memory – or describe a panic attack – with the depth needed for effective therapy.
The therapeutic alliance – the trust and connection between therapist and client – also strengthens when language barriers are removed. When you don’t have to search for words or simplify your feelings, you can go deeper faster. This is especially important for trauma work, EMDR therapy, and couples therapy, where precision of expression matters.
At Therapsy, the clinical team speaks 14 languages: Italian, English, French, Spanish, German, Portuguese, Ukrainian, Russian, Greek, Arabic, Urdu, Hebrew, Hindi, and Persian (Farsi). The Clinical Director, Dr. Francesca Adriana Boccalari, personally matches each client with a therapist who speaks their language and understands their cultural background. This is not a luxury – it is a clinical necessity.
What should expats know about Italy’s new community-based mental health services?
The National Mental Health Plan 2025-2030 introduces primary care psychologists in community health centres across Italy, which could represent a meaningful new resource for residents – including expats. These psychologists will offer free, non-medicalized support for mild to moderate issues such as stress, adjustment difficulties, and low mood.
However, there are important caveats for the international community:
Language: These services will be delivered in Italian. While this is valuable for expats who are fluent in Italian, it will not serve the majority of international residents who need therapy in another language.
Implementation timeline: The Plan sets a framework through 2030, but actual implementation depends on regional governments and local health authorities. Some regions may move quickly; others may take years.
Scope: Community psychologists will handle mild to moderate cases. If you’re dealing with trauma, severe anxiety, depression, OCD, or complex relationship issues, you’ll still need specialized private care.
What this means for you: The new community services are a positive step for Italy’s mental health system overall. For expats, they may offer a useful first point of contact – especially for those who speak Italian. But for specialized, multilingual, culturally informed therapy, private services like Therapsy remain the most effective option.
Therapsy’s team includes therapists trained in CBT, EMDR, Schema Therapy, systemic-relational therapy, and other evidence-based approaches. Dr. Boccalari provides ongoing clinical supervision to ensure consistent quality across the entire team – a level of oversight that community services are unlikely to match.
How does Therapsy help expats navigate Italy’s mental health system?
Therapsy was created specifically to solve the problems that expats face when trying to access mental health care in Italy. Founded in 2023 and led clinically by Dr. Francesca Adriana Boccalari, Therapsy was born from a simple observation: mental health services in Italy for expats were fragmented and hard to access, and expats deserved a space where they could find psychological support in their own language.
The Therapsy process
Getting started is simple and removes the barriers that typically delay expats from seeking help:
- Fill out the form at therapsy.it – the Clinical Director contacts you within 12 hours via WhatsApp
- Free personal matching – Dr. Boccalari or her onboarding assistant talks with you on WhatsApp and chooses the therapist best suited to you
- Free first assessment call – you meet the therapist chosen for you, at no cost, to see if the fit is right
- Start your journey – flexible sessions, online or in-person, with the option to rematch if needed
What sets Therapsy apart
Therapsy’s approach is built on six key differentiators:
- 14 languages – not just English, but Italian, French, Spanish, German, Portuguese, Ukrainian, Russian, Greek, Arabic, Urdu, Hebrew, Hindi, and Persian (Farsi)
- Human-matched therapy – Dr. Boccalari personally evaluates every case; no chatbots or automated questionnaires
- 90+ locations across 24 cities – in-person sessions in Milan, Rome, Florence, Turin, Bologna, and many more
- Online sessions – accessible from anywhere in Italy and internationally
- Free matching and free first assessment call – no financial risk to get started
- Institutional trust – partnered with Cigna, World Food Programme, FAO, MUR, InterNations, IED, and Istituto Marangoni
“I found Therapsy online, contacted them, they responded right away. Dr. Eleni Karliampa understands my culture and language. I never felt judged.” – Polina V., via Trustpilot
What are expats in Italy saying about their therapy experience?
Real experiences from Therapsy clients highlight how multilingual, culturally sensitive therapy makes a tangible difference.
“For the past year I have been seeing Filomena Rita Guarino online. She is so calm and understanding, I never felt judged.” – Emily O., via Trustpilot
“Francesca matched me with Doctor Damiani, who is an extremely great listener. I have achieved significant breakthroughs.” – Alex C., via Trustpilot
“Dr. Leelt Retta Gebru has a calm, understanding presence that makes it easy to open up, even about difficult topics.” – Hira B., via Trustpilot
These testimonials reflect a pattern: when expats find a therapist who speaks their language and understands their cultural experience, they engage more deeply, stay in therapy longer, and report better outcomes. Therapsy’s Trustpilot rating of 4.8/5 – “Excellent” – is built on this foundation of personalized, multilingual care.
How to get started with mental health support in Italy: step by step
If you’re an expat in Italy and you’re ready to take the first step toward mental health support, here’s a practical guide:
Step 1: Assess your needs. Are you dealing with mild stress and adjustment, or something more complex like anxiety, depression, trauma, or relationship issues? This helps determine whether public or private services are right for you.
Step 2: Check your insurance. If you have international health insurance (Cigna, Allianz, or similar), check whether psychotherapy sessions are covered. Many policies cover private therapy.
Step 3: Explore the Bonus Psicologo. If you have Italian residency and a valid ISEE under 50,000 euros, you may qualify for up to 1,500 euros toward therapy. Visit the INPS website when the application window opens. The bonus cannot be used for sessions at Therapsy.
Step 4: Choose your pathway. For Italian-speaking expats with mild needs, the new community psychologists may be a good starting point. For multilingual, specialized care, private services are usually the best option.
Step 5: Contact Therapsy. Visit therapsy.it and fill out the contact form. The Clinical Director or her onboarding assistant will write to you on WhatsApp within 12 hours to discuss your needs and match you with a therapist who speaks your language.
Step 6: Start your free assessment call. Meet your matched therapist at no cost to see if the fit is right. There’s no obligation to continue.
Step 7: Begin your therapy journey. Choose between online and in-person sessions and keep a regular rhythm. If the fit isn’t right, Therapsy will rematch you at no extra cost.
FAQ: Mental health services in Italy for expats
Can expats access the Italian public mental health system?
Yes. People registered with the national health service (SSN) can use public mental health services, including the Centro di Salute Mentale (CSM). In an emergency, hospitals also treat people who are not registered, though they may charge for the care. Do not count on finding staff who work in English.
What is the Bonus Psicologo and can foreigners apply?
The Bonus Psicologo is a government-funded contribution of up to 1,500 euros for private psychotherapy. Foreigners with Italian residency and a valid ISEE under 50,000 euros can apply through the INPS portal. No citizenship requirement exists. The bonus can be used only with psychotherapists on the INPS list, and Therapsy is not part of the scheme.
How much does private therapy cost in Italy?
Private therapy in Italy typically costs between 60 and 120 euros per session. At Therapsy, individual therapy starts from 70 euros per session and couples therapy from 100 euros per session, with transparent pricing and no hidden fees.
Does Therapsy accept insurance?
Some Therapsy clients have been reimbursed by Cigna, and Therapsy works with several EAP providers. If your international insurance covers therapy, your sessions may be partially or fully reimbursed. Contact Therapsy to verify coverage.
What languages does Therapsy offer therapy in?
Therapsy offers therapy in 14 languages: Italian, English, French, Spanish, German, Portuguese, Ukrainian, Russian, Greek, Arabic, Urdu, Hebrew, Hindi, and Persian (Farsi). With 50+ therapists across the team, Therapsy can match you with a professional who speaks your mother tongue.
Do I need a referral to see a therapist in Italy?
For private therapy, no referral is needed. You can contact Therapsy directly. For public mental health centres, access is direct under national rules, although some centres prefer a referral from your family doctor.
What mental health issues does Therapsy treat?
Therapsy’s clinical team treats anxiety, depression, trauma and PTSD, OCD, burnout, relationship issues, grief, anger management, low self-esteem, psychosomatic symptoms, and more. Therapeutic approaches include CBT, EMDR, Schema Therapy, and systemic-relational therapy.
Is online therapy as effective as in-person therapy?
Research consistently shows that online therapy is equally effective as in-person therapy for most conditions, including anxiety and depression. Therapsy offers both options, so you can choose what works best for your schedule and location.
How does the new National Mental Health Plan affect expats?
Italy’s 2025-2030 Plan introduces community-based psychologists and improved public services. While these reforms are positive, they will primarily serve Italian speakers. Expats needing multilingual or specialized care will continue to benefit most from private services like Therapsy.
How quickly can I start therapy with Therapsy?
Therapsy’s Clinical Director typically contacts new clients within 12 hours of receiving a request. Then you have a free first assessment call with the therapist chosen for you; when regular sessions start depends on your needs and availability.
About this article
Written by: Dr. Francesca Adriana Boccalari, Clinical Director at Therapsy
Dr. Boccalari is a licensed Clinical Psychologist and Psychotherapist with over 10 years of experience. She graduated with honors in Clinical Psychology from Vita Salute San Raffaele University and specializes in Cognitive Behavioral Therapy (CBT), EMDR, and Schema Therapy. She trained in Milan, New York, and Singapore.
Dr. Boccalari is responsible for the listening desk service at IED (Istituto Europeo di Design) and collaborates with Istituto Marangoni as psychotherapist consultant. She was among the first psychotherapists to promote therapy in English in Milan and has worked with expats and foreign students throughout her clinical career.
At Therapsy, she personally evaluates each new client and matches them with the therapist best suited to their needs. She provides ongoing supervision to the entire clinical team, ensuring consistent quality of care.
Reviewed by: Therapsy Clinical Team
Last updated: April 2026
Trustpilot rating: 4.8/5 – “Excellent”
Ready to talk to someone who speaks your language?
You don’t have to navigate Italy’s mental health system alone. Whether you’re dealing with anxiety, depression, relationship struggles, or the everyday challenges of living abroad, Therapsy connects you with a licensed therapist who understands your language and your experience.
