Psychosocial Healthcare Centres (CAPS) in Brazilian Mental Health Policy, 2008-2017

Abstract

Psychosocial Healthcare Centres have been promoted by Brazilian mental health policy along with a guaranteed financing from the Ministry of Health. This paper used Strata 2014 data to analyse the extent of Psychosocial Healthcare Centres care capacity available for user as the central driver of mental health care in Brazil. Retrospective, descriptive study with secondary data analysis of services was undertaken using data from Brazilian federal government databases. Brazil does not have 100% mental health care coverage and our analysis, using the Brazilian Health Ministry criteria, identified only 36% (842) municipalities have been adequately resourced. Our analysis identified that while the number of CAPS units increased around 100%, due to increased extra-hospital and community services in the period, effective cover reduced due to budget cuts and increases as a result of rights to access. The Ministry of Health identified coverage in the ratio of 1 CAPS / 100 thousand inhabitants, although CAPS availability is not the only parameter for assessing mental health coverage. Within municipalities, the mental health network is not synonymous with CAPS nor its quality. We believe that the priority given to investing in CAPS, without guaranteeing resources for other mental health intervention, may negate the efforts of building of a network of new de-institutionalising services which replaced traditional models.