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Free and low-cost therapy in San Antonio

You don't need insurance or much money to get help in San Antonio. Here's where Bexar County offers free or sliding-scale counseling, crisis care and help with drinking or drugs, and the numbers to call.

Updated October 25, 2026. General information, not medical, legal or insurance advice. Programs and phone numbers change, so call ahead.

If you need help now: call 911 in an emergency. In a mental health or substance use crisis, call or text 988, any time. In Bexar County you can also call the CHCS crisis line, 210-223-7233, day or night.

Help right now

WhoNumberWhen to call
Emergency911Someone is in danger, badly hurt, or may have overdosed.
988 Suicide & Crisis LifelineCall or text 988Thoughts of suicide, or any mental health or substance use crisis. Free, 24/7. For Spanish, press 2 or text AYUDA.
CHCS crisis and substance use line210-223-7233 (210-223-SAFE) or 1-800-316-9241Bexar County's own crisis line, 24 hours a day.
SAMHSA National Helpline1-800-662-4357Free, confidential treatment referrals, 24/7, in English and Spanish.

Anyone in a psychiatric crisis can get help right away from the county's mental health authority, even if they've never been a client. You don't need insurance or money to call.

The Center for Health Care Services (CHCS)

The Texas Health and Human Services Commission (HHSC) names a local mental health authority for every county: a public agency that runs crisis services and treatment for people who can't get care elsewhere. In Bexar County, it's the Center for Health Care Services, often called CHCS.

  • What they do: crisis care, counseling, psychiatric care and medication, case management, and treatment for substance use, for adults and children.
  • Who qualifies for ongoing care: adult outpatient care is for Bexar County residents 18 and older with a condition on the state's priority list, mostly serious ones such as major depression, bipolar disorder or schizophrenia. Children 3 and older are seen too. If CHCS isn't the right fit, they'll refer you elsewhere.
  • Cost: CHCS says no one is turned away because they can't pay. Fees are on a sliding scale by family size and income, set after a short financial assessment.
  • How to start: call 210-261-CHCS (2427) for a first screening, by phone or in person. Bring a photo ID, proof of income, proof of where you live, any insurance card and a list of your medicines.

CHCS's Restoration Center, at 601 N. Frio St., has crisis care, a sobering unit and detox (help getting through withdrawal safely).

Help with alcohol or drugs

Texas pays for substance use treatment for people who can't afford it. The way in is OSAR (Outreach, Screening, Assessment and Referral), which HHSC calls the first point of contact for treatment. The only requirement is that you live in Texas. A counselor works out what care you need, from outpatient counseling to detox or a residential program, and helps you get a spot.

  • Bexar County's OSAR is run by CHCS. Call 210-261-3076, or the 24-hour line, 210-223-7233.
  • Cost: state help paying for treatment depends on your income, expenses and other resources. Sometimes you pay part of the cost.
  • Also try SAMHSA's helpline, 1-800-662-4357, for state-funded and sliding-fee programs, or FindTreatment.gov for licensed programs near you.

Searching for "free rehab in San Antonio"? Start with OSAR. Our guide to IOP vs PHP vs weekly therapy explains the levels of care you may hear about.

Sliding-scale and free counseling

A sliding scale means a lower fee when your income is lower. If CHCS isn't the right fit, try these.

Community health centers

Federally qualified health centers (FQHCs) get federal funding to care for people with or without insurance. Fees slide by income and household size for incomes up to twice the federal poverty level, and no one is turned away for being unable to pay. HRSA's Find a Health Center lists them all. Two in San Antonio offer counseling:

  • CentroMed: bilingual, master's-level therapists see children and adults for depression, anxiety, grief, substance use, family violence and more, at several clinics. Call 210-922-7000.
  • CommuniCare Health Centers: behavioral health care at several San Antonio campuses. New patients call 210-233-7000. If you're uninsured, you'll meet with a member services representative first to apply for the discount.

University training clinics

Graduate students in counseling or psychology see clients here, closely supervised by licensed faculty. Fees are low or free.

Support from people who've been there

NAMI Greater San Antonio, the local branch of the National Alliance on Mental Illness, runs free support groups and classes for people living with a mental health condition and for their families. Call 210-734-3349.

Medicaid and CHIP

Medicaid and CHIP (the Children's Health Insurance Program) cover counseling and substance use treatment. Texas Medicaid mainly covers children, pregnant women, parents and caretakers with low incomes, people with disabilities, and people 65 and older. Even if you don't qualify, your children might.

  • Apply at YourTexasBenefits.com, or call 2-1-1 (or 877-541-7905), pick a language, then press 2.
  • Use your plan: most Texans with Medicaid get it through a health plan they choose (managed care), such as STAR. See providers in your plan's network; the member number on your card can help you find one.

Our guide to using insurance for therapy in Texas explains the programs, changing plans and who to call when you can't get care.

How Cima Find Care can help

Cima Find Care is a free directory of Texas therapists, counselors, LCDCs (licensed chemical dependency counselors), recovery coaches, psychiatric prescribers and IOP/PHP programs. We check each provider's Texas license or certification before they're listed.

Our listings are growing. We add Texas providers as each license is checked, so you may only see a few in San Antonio for now. Meanwhile, the places above can help. See our guides for Austin and El Paso.

Questions people ask

Is there really free therapy in San Antonio?

Yes. UTSA's Sarabia Family Counseling Center offers free counseling, and Our Lady of the Lake's clinic is free for clients with Medicaid. CHCS and the community health centers charge on a sliding scale and say they don't turn people away because they can't pay.

I don't have insurance. Where should I start?

For serious symptoms, such as deep depression or hearing voices, call CHCS at 210-261-2427. For stress, anxiety, grief or relationship problems, try a training clinic or community health center. In a crisis, call 988.

How do I get into free or low-cost rehab in San Antonio?

Call the Bexar County OSAR at 210-261-3076. They'll screen you and help you get into a state-funded program. SAMHSA's helpline, 1-800-662-4357, can help too.

Can I get help in Spanish?

Yes. 988 has Spanish-speaking counselors: press 2, or text AYUDA to 988. SAMHSA's helpline answers in Spanish. CentroMed has bilingual therapists, and some St. Mary's counselors speak Spanish.

Do I have to live in Bexar County?

For CHCS's ongoing adult services, yes. Crisis help is for anyone, and OSAR serves anyone living in Texas. Ask the clinics about their rules when you call.

Sources

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