The mental health system in Brazil: Policies and future challenges View Full Text


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Article Info

DATE

2008-09-05

AUTHORS

Mario D Mateus, Jair J Mari, Pedro GG Delgado, Naomar Almeida-Filho, Thomas Barrett, Jeronimo Gerolin, Samuel Goihman, Denise Razzouk, Jorge Rodriguez, Renata Weber, Sergio B Andreoli, Shekhar Saxena

ABSTRACT

BACKGROUND: The aim of this paper is to assess the mental health system in Brazil in relation to the human resources and the services available to the population. METHODS: The World Health Organization Assessment Instrument for Mental Health Systems (WHO AIMS) was recently applied in Brazil. This paper will analyse data on the following sections of the WHO-AIMS: a) mental health services; and b) human resources. In addition, two more national datasets will be used to complete the information provided by the WHO questionnaire: a) the Executive Bureau of the Department of Health (Datasus); and b) the National Register of Health Institutions (CNS). RESULTS: There are 6003 psychiatrists, 18,763 psychologists, 1985 social workers, 3119 nurses and 3589 occupational therapists working for the Unified Health System (SUS). At primary care level, there are 104,789 doctors, 184, 437 nurses and nurse technicians and 210,887 health agents.The number of psychiatrists is roughly 5 per 100,000 inhabitants in the Southeast region, and the Northeast region has less than 1 psychiatrist per 100,000 inhabitants. The number of psychiatric nurses is insufficient in all geographical areas, and psychologists outnumber other mental health professionals in all regions of the country. The rate of beds in psychiatric hospitals in the country is 27.17 beds per 100,000 inhabitants. The rate of patients in psychiatric hospitals is 119 per 100,000 inhabitants. The average length of stay in mental hospitals is 65.29 days. In June 2006, there were 848 Community Psychosocial Centers (CAPS) registered in Brazil, a ratio of 0.9 CAPS per 200,000 inhabitants, unequally distributed in the different geographical areas: the Northeast and the North regions having lower figures than the South and Southeast regions. CONCLUSION: The country has opted for innovative services and programs, such as the expansion of Psychosocial Community Centers and the Return Home program to deinstitutionalize long-stay patients. However, services are unequally distributed across the regions of the country, and the growth of the elderly population, combined with an existing treatment gap is increasing the burden on mental health care. This gap may get even wider if funding does not increase and mental health services are not expanded in the country. There is not yet a good degree of integration between primary care and the mental health teams working at CAPS level, and it is necessary to train professionals to act as mental health planners and as managers. Research on service organization, policy and mental health systems evaluation are strongly recommended in the country. There are no firm data to show the impact of such policies in terms of community service cost-effectiveness and no tangible indicators to assess the results of these policies. More... »

PAGES

12-12

References to SciGraph publications

  • 2001-05. Restructuring mental health: a South American survey in SOCIAL PSYCHIATRY AND PSYCHIATRIC EPIDEMIOLOGY
  • 1992-05. A psychiatric unit in a general hospital in Brazil: predictors of length of stay in SOCIAL PSYCHIATRY AND PSYCHIATRIC EPIDEMIOLOGY
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    http://scigraph.springernature.com/pub.10.1186/1752-4458-2-12

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    http://dx.doi.org/10.1186/1752-4458-2-12

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    https://app.dimensions.ai/details/publication/pub.1001278507

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/18775070


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    116 primary care level
    117 professionals
    118 program
    119 psychiatric hospital
    120 psychiatric nurses
    121 psychiatrists
    122 psychologists
    123 psychosocial centres
    124 questionnaire
    125 rate
    126 rate of bed
    127 rate of patients
    128 ratio
    129 region
    130 relation
    131 research
    132 resources
    133 results
    134 sections
    135 service organizations
    136 services
    137 social workers
    138 south
    139 southeast region
    140 stay
    141 such policies
    142 system
    143 system evaluation
    144 tangible indicators
    145 team
    146 technicians
    147 terms
    148 therapists
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