The mental health care model in Brazil: analyses of the funding, governance processes, and mechanisms of assessment

Abstract

OBJECTIVE This study aims to analyze the current status of the mental health care model of the Brazilian Unified Health System, according to its funding, governance processes, and mechanisms of assessment.METHODS We have carried out a documentary analysis of the ordinances, technical reports, conference reports, normative resolutions, and decrees from 2009 to 2014.RESULTS This is a time of consolidation of the psychosocial model, with expansion of the health care network and inversion of the funding for community services with a strong emphasis on the area of crack cocaine and other drugs. Mental health is an underfunded area within the chronically underfunded Brazilian Unified Health System. The governance model constrains the progress of essential services, which creates the need for the incorporation of a process of regionalization of the management. The mechanisms of assessment are not incorporated into the health policy in the bureaucratic field.CONCLUSIONS There is a need to expand the global funding of the area of health, specifically mental health, which has been shown to be a successful policy. The current focus of the policy seems to be archaic in relation to the precepts of the psychosocial model. Mechanisms of assessment need to be expanded.

Analysis of Potential Drug Interactions in Brazilian Mental Health Services: Prevalence and Associated Factors

“…Psychosocial Care Centers (CAPS -from Portuguese Centro de Atenção Psicossocial) are strategic services belonging to the Psychosocial Care Network and the Brazilian health system. 9 Identifying the most frequent potential interactions may be important in subsidizing clinical practice pharmacovigilance, and planning initiatives to improve patient safety and rational drug use. The aim of the present study was to identify the most frequent potential drug interactions on the prescriptions of CAPS users.…”

Transtorno afetivo bipolar: determinantes sociais de saúde, adesão ao tratamento e distribuição espacial [Bipolar affective disorder: health social determinants, adherence to treatment and space distribution] [Trastorno afectivo bipolar: determinantes sociales de la salud, adherencia al tratamiento y distribución del espacio]

“…Observou-se que há maior percentual de pessoas com baixa renda entre os participantes. Pesquisa ) revela a mesma correlação entre renda e adesão ao tratamento 25 . O mercado formal de trabalho é pautado por uma concepção histórica de que o louco é incapaz e improdutivo para as relações de trabalho articuladas pelo capitalismo 23 , reafirmando o estigma.…”

Assessment of the procedures record by professionals of Psychosocial Care Centers

“…This is because, at present, there is no national scope of assessment that can analyze mental health policy in its macrostructural scope. The assessments presented annually by the Technical Area of Mental Health make some cuts of the model related to the expansion and opening of services, reduction of beds and financed amount, without advancing in the analyzes (2) . Therefore, the need for qualification is due to the fact that the professionals, when handling the tools, consider that there is a lack of correspondence between the record of actions and the work process developed in the CAPS related to the distancing of the different levels of SUS management from the work that is developed these services.…”

“…The implementation of Centros de Atenção Psicossocial (Psychosocial Care Centers-CAPS) emerged from the Brazilian Psychiatric Reform and required the development of a set of knowledge and psychosocial skills of the professionals in the area, and this service there is the complex task of articulating with other devices of a Rede de Atenção Psicossocial (Psychosocial Care Network-RAPS) to guarantee the integrality of care. Considering this premise, it will be important to assess how the psychosocial care in the Sistema Único de Saúde (Brazilian Unified Health System-SUS) has been conducted and how it has become necessary for the actions implemented in the CAPS to be monitored and evidenced to support the effectiveness and superiority of this care proposal (1)(2)(3)(4)(5) .…”