Impasses e desafios para consolidação e efetividade do apoio matricial em saúde mental no Brasil

Treichel, Carlos Alberto dos Santos; Campos, Rosana Teresa Onocko; Campos, Gastão Wagner de Sousa

doi:10.1590/interface.180617

Cited by 39 publications

(67 citation statements)

References 41 publications

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“…There may be several factors that lead to the di culty of operating this service. A literature review conducted previously [9] suggested that although it has been over 10 years since the implementation of matrix support in the Brazilian health system, it remains common for health networks to face problems such as: 1) lack of clarity in guidelines regarding the sharing of cases; 2) bureaucratization of the referral between services; 3) negative attitudes of professionals in dealing with mental health related issues; and 4) lack of institutionalized space and time for sharing of cases. It is noteworthy that these aspects are also highlighted in the study of international counterparts of this methodology, such as shared care [24].…”

Section: Discussionmentioning

confidence: 99%

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Knowledge by Primary Care of mental health patients treated at outpatient specialized services: prevalence and associated factors

Treichel¹,

Bakolis²,

Campos³

2021

Preprint

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Background Although matrix support seeks to promote the integration of Primary Care with specialized mental health services in Brazil, little is known about the quantitative impact of this strategy on the sharing of cases between different levels of care. The aim of this study was to investigate the prevalence and factors associated with knowledge by Primary Care of mental health patients treated at outpatient specialized services in a medium-sized city in Brazil with recent implementation of matrix support. Methods This is a document-based cross-sectional study, conducted through the analysis of 1198 patients’ medical records. Crude and adjusted associations with the outcome were explored using logistic regression. Results The prevalence of cases known by Primary Care was 40% (n = 479). Evidence was found for associations between the outcome and the patients being over 30 years old, and referral by emergency or hospital services. There was, conversely, an inverse association between the outcome and status as a patient from the Outpatient Clinic or from the Psychosocial Care Center for psychoactive substance misuse. Conclusions Even with the provision of mechanisms for network integration, such as matrix support, our results suggest that more groundwork is necessary to ensure that the sharing of cases between Primary Care and specialized services is effective.

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Section: Discussionmentioning

confidence: 99%

“…However, although there have been signi cant contributions to the literature regarding facilitators and barriers to matrix support services [7,8], little is known about the system's quantitative impact on the sharing of cases between different levels of care [9].…”

Section: Introductionmentioning

confidence: 99%

Knowledge by Primary Care of mental health patients treated at outpatient specialized services: prevalence and associated factors

Treichel¹,

Bakolis²,

Campos³

2021

Preprint

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“…Consistently with its historical backstepping, the ill-advised ruling reestablished in the RAPS a secondary level of care through specialized mental health teams, opening the way for reinstalling hierarchical and stand-alone psychiatric outpatient clinics. This again shows the field's active inclination towards the hegemony of biomedical practices, since the adequate implementation of Centers to Support Family Health (NASF) would solve the linkage between levels of care, as shown by some recent studies 10 .…”

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confidence: 83%

Saúde mental no Brasil: avanços, retrocessos e desafios

Campos

2019

Cad. Saúde Pública

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It seems impossible now to conceive of Brazil's Psychiatric Reform without contextualizing in recent history the creation of the Brazilian Unified National Health System (SUS) in the 1988 Constitution and the advent of the progressive governments in the early 2000s. Despite the permanent financial crisis and budget constraints that have dragged on ever since the creation of the SUS and its regulation, it is undeniable that re-democratization and the Psychiatric Reform process allowed the creation of mental healthcare networks throughout the country and with major expansion of community-based services. This process, based on humanitarian values and guaranteed rights, was marked constantly by a strong ideological dispute with a certain sector of Brazilian psychiatry. And although civil society's participation was widely touted and actually implemented in some large Brazilian cities, in general such participation was actually weak. Although the Reform's nouvelle familiar emphasizes patients' and workers' movements as founding and important movements, they were not successful in spreading across Brazil, so that the Reform was impelled as a public health policy and not as a demand by civil society. By this, we do not mean to deny that there was a link between these areas, but to contribute to understanding the current directions and possible defenses for the Reform. After nearly 30 years of the Reform, Brazil's research production now allows us to highlight some consolidated results in the scientific literature, featuring the following. There was actually a major shift in expenditures in mental health, with community-based services receiving more budget funds than hospitals since 2006. The virtual majority of community mental health services are Centers for Psychosocial Care (CAPS) in the modalities I, II, or III (with overnight beds). Beds were closed in psychiatric hospitals, now known to be ineffective according to the international literature (this process is still unfinished, and there are various places in Brazil that still have psychiatric hospitals, with dubiously effective practices and suspicions of mistreating patients). The expansion of community-based services has come to a virtual standstill since 2011, and data are lacking since 2015, in an unfortunate loss of transparency and accountability by the Ministry of Health. Despite the important expansion of coverage with community services, there was a persistent lack of scale for some relevant resources to implement recovery in society, such as the Program "De Volta para Casa" (Return Home), community contact centers, income generation centers, etc. Meanwhile, the community-based services have shown (like all the services in the SUS) a serious institutional weakness and budget constraints due to insufficient funding. Some studies have identi

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“…Agora em 2020, deve atingir entre 15% e 20% da população mundial. A depressão ocupará o 2º lugar na referida classificação, perdendo apenas para as doenças cardíacas (1,3,4) . O termo depressão era usado, inicialmente, para designar sintomas ou caracterizar estados mentais, sendo que o nome da doença era melancolia, termo cunhado há mais de 25 séculos; que, além de indicar uma das doenças mentais, também correspondia a um tipo de temperamento, um estado emocional baixo, infeliz, desanimado e triste (3,5) .…”

Section: Introductionunclassified

“…De acordo com Farias (6) , as principais classes terapêuticas no campo da saúde mental seguem o seguinte percentual: 28% dos medicamentos dispensados são antidepressivos, 24% benzodiazepínicos, 21% antiepilépticos, 10% antipsicóticos, 8% barbitúricos, 6% analgésico de ação central, 2% antiparkinsoniano e 1% inibidor de receptor H1. A depressão será a doença mais comum no mundo em 2030 (1,3,4) . Neste contexto, este trabalho teve como objetivo conhecer o perfil de utilização de medicamentos pelos utentes do Serviço de Assistência Psicossocial (SAPS) do Instituto de Ciências da Saúde (ICS) da Universidade Federal do Pará (UFPA).…”

Section: Introductionunclassified

Utilização De Medicamentos Por Discentes Que Utilizam O Serviço De Assistência Psicossocial Do Instituto De Ciências Da Saúde Da Universidade Federal Do Pará

Batista¹,

Braga²,

Soler³

2020

RACF

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Introdução: A saúde mental pode incluir a capacidade de um indivíduo de apreciar a vida e procurar um equilíbrio entre as atividades e os esforços para atingir a resiliência psicológica. Admite-se, entretanto, que o conceito de Saúde Mental é mais amplo que a ausência de transtornos mentais. Objetivos: Conhecer o perfil de utilização de medicamentos em discentes utentes do Serviço de Assistência Psicossocial do Instituto de Ciências da Saúde da Universidade Federal do Pará. Métodos: Estudo transversal, prospectivo, feito por amostragem de conveniência e consecutiva, realizado entre janeiro e junho de 2017, utilizando-se de estratégias aplicadas ao cuidado farmacêutico. Resultados e discussão: Os discentes são predominantemente pardos e morenos, idade média de 24 anos, renda familiar de até 3 salários mínimos e de amplo espectro quanto ao extrato social. Significativo grau de conhecimento de utentes sobre seu tratamento farmacológico e dos medicamentos prescritos. Houve necessidade de intervenção farmacêutica quanto a revisão de estratégias farmacoterapêuticas prescritas e de conciliação de medicamentos. Regular adesão ao tratamento farmacológico. Regular satisfação dos utentes com sua qualidade de vida. Conclusões: Infere-se que utentes com diagnóstico de depressão atendidos no Serviço de Assistência Psicossocial do Instituto de Ciências da Saúde da Universidade Federal do Pará apresentam um perfil regular quanto a qualidade da prescrição e o uso de medicamentos; assim como quanto a sua percepção de qualidade de vida.

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Impasses e desafios para consolidação e efetividade do apoio matricial em saúde mental no Brasil

Cited by 39 publications

References 41 publications

Knowledge by Primary Care of mental health patients treated at outpatient specialized services: prevalence and associated factors

Knowledge by Primary Care of mental health patients treated at outpatient specialized services: prevalence and associated factors

Saúde mental no Brasil: avanços, retrocessos e desafios

Utilização De Medicamentos Por Discentes Que Utilizam O Serviço De Assistência Psicossocial Do Instituto De Ciências Da Saúde Da Universidade Federal Do Pará

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