In an opinion piece published in HealthNews on September 9, 2026, Lúcio Silva, a psychiatrist at The Clinic of Change and a member of the Academy of Brain Stimulation, addresses one of the blind spots in the public debate on mental health in Portugal: patients who do not respond to conventional treatments and the alternative therapies available to help them.
The problem no one wants to face
The starting point is the scale of the problem. According to the health profile of Portugal published by the OECD using 2019 data, 22% of the Portuguese population suffered from some form of mental health disorder, above the European average of 16.7%. The impacts are manifold: direct costs associated with medical consultations, hospitalizations, and medication, as well as consequences for the social fabric, including inability to work, absenteeism, and early retirement.
Lúcio Silva acknowledges that it is a positive development that there is less stigma surrounding mental health and that more people are seeking help. But he points out a blind spot that is rarely discussed: treatment-resistant cases. It is estimated that between 30% and 40% of patients with depression develop forms of the condition that are resistant to conventional pharmacological treatment. The question that inevitably arises is: what alternatives exist for those who continue to suffer despite having already undergone conventional treatments?
Two innovative treatments backed by scientific evidence
For the psychiatrist, the answer lies in therapeutic innovation. In the article, he highlights two treatments that have been integrated into clinical practice in Portugal and that serve as effective tools for treatment-resistant cases.
The first is psychedelic-assisted psychotherapy. Lúcio Silva begins by dispelling misconceptions: this is not recreational use, but rather interventions carried out in a clinical setting, following a rigorous evaluation, with medical and psychological supervision, in accordance with approved and tested protocols. Ketamine, in particular, has shown enormous potential in cases of treatment-resistant depression, due to its rapid onset of action and a mechanism of action distinct from that of conventional antidepressants. Several European countries, such as Norway, France, and the Czech Republic, have taken significant steps toward integrating this approach into their public health systems.
The second is Transcranial Magnetic Stimulation (TMS), a noninvasive brain neuromodulation technique performed on an outpatient basis, without anesthesia or sedation, that uses magnetic fields to stimulate brain circuits associated with emotional regulation. International evidence supports its use in treatment-resistant depression, with meta-analyses indicating response rates between 50% and 60% and remission rates between 30% and 40%.
A Call to Action
Lúcio Silva’s conclusion is a direct appeal. For many patients, therapeutic innovation represents a concrete possibility of regaining a functional and independent life. For Portuguese society, it represents a course of action with the potential to improve mental health care and reduce the impact of functional disability on the social fabric. “Mental health policies that aim to be effective must incorporate new knowledge and approaches whenever scientific evidence justifies it,” he writes. And he concludes with an image that aptly sums up his argument: “We are painting a picture without using all the colors at our disposal. For many patients, that can be the difference between a life experienced in color or in black and white.”
Read the full opinion piece in the online edition of HealthNews – SAPO.
