Availability of mental health care and mental health disorders in Brazil

Abstract

Purpose We aimed to describe the prevalence of 12-month reported MHD and evaluate associations with availability mental health (MH) care in Brazil.Methods Data from a nationwide probability survey (n = 16,273) and from the National Registry of Health Services have been analyzed. The main outcomes were 12-month reported diagnosis/treatment for anxiety, depression, and severe MHD. Multivariate logistic regressions were performed to assess the associations of the rates of psychiatrists, outpatient MH services (CAPS) and primary health care services (PHC) with the outcomes.Results The overall prevalence of anxiety, depression, bipolar disorder and schizophrenia were 15.5% (95%CI:14.4–16.6), 7.3% (95%CI:6.6–7.9), 1.0% (95%CI:0.8–1.3), and 0.4% (95%CI 0.3–0.5), respectively, with lower prevalences observed in less developed macroregions. The rate of psychiatrists varied from 1.52 (North) to 12.26 (South)/100,000 inhabitants, the rate of CAPS from 1.52 (North) to 2.72 (Northeast), and the rate of PHC from 26.12 (Southeast) to 52.25 (Northeast). Individuals living in regions with higher rates of psychiatrists and PHCs were more likely to report anxiety and depression, while those living in regions with higher rates of CAPS were more likely report severe MHD.Conclusion The distribution of services mirrors the emphasis on PHC and CAPS to enhance equity within the Brazilian Universal Health System. However, diagnostic and treatment rates remain elevated in regions with larger psychiatrist presence. Addressing information gaps is imperative to optimize MH policies and resources allocation.