BackgroundPathways to care are actions and strategies employed by individuals in order to get help for health-related distress and the related processes of care providers. On several systematic reviews regarding pathways to mental health care (PMHC), studies regarding South American countries were not present. This review synthesizes qualitative and quantitative research about PMHC in Brazil.MethodsLILACS, MEDLINE and SCIELO databases were searched for papers regarding PMHC in Brazil. The results were organized in pathway stages, based on Goldberg and Huxley’s ‘model of Levels and Filters’ and on Kleinman’s framework of ‘Popular, Folk and Professional health sectors’. Analysis also considered the changes in national mental health policy over time.Results25 papers were found, with data ranging from 1989 to 2013. Complex social networks were involved in the initial recognition of MH issues. The preferred points of first contact also varied with the nature and severity of problems. A high proportion of patients is treated in specialized services, including mild cases. There is limited capacity of primary care professionals to identify and treat MH problems, with some improvement from collaborative care in the more recent years. The model for crisis management and acute care remains unclear: scarce evidence was found over the different arrangements used, mostly stressing lack of integration between emergency, hospital and community services and fragile continuity of care.ConclusionsThe performance of primary care and the regulation of acute demands, especially crisis management, are the most critical aspects on PMHC. Although primary care performance seems to be improving, the balanced provision and integration between services for adequate acute and long-term care is yet to be achieved.Electronic supplementary materialThe online version of this article (10.1186/s13033-018-0237-8) contains supplementary material, which is available to authorized users.

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Objetivo: identificar publicações nacionais brasileiras e internacionais na área de saúde mental sobre avaliação de serviços, destacando as formas de participação dos usuários. Método: trata-se de uma revisão sistemática qualitativa da literatura, que seguiu as orientações do PRISMA e utilizou duas plataformas internacionais que agregam um número significativo de bases de dados, com os descritores (saúde mental e avaliação) no período de 2004 a 2016. Resultados: levantou-se 4.735 artigos completos; tendo elegibilidadefinal de 137 artigos para leitura integral, sendo 44 incluídos na análise final. Percebe-se que há pesquisas sobre avaliação de serviços de saúde mental com a participação dos usuários no Brasil, mas ainda em número menor em comparação com Inglaterra, Austrália e EUA. Conclusão: a forma de participação dos usuários nas avaliações dos serviços, tanto no Brasil quanto em outros países, ainda é um desafio. Há pouco protagonismo dos usuários. No Brasil, coloca-se o desafio ainda de estruturar avaliações sistemáticas dos serviços públicos, com multiplicidade de métodos avaliativos e envolvendo todos os atores.

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