The mental health system in Brazil: Policies and future challenges

<p>Abstract</p> <p>Background</p> <p>The aim of this paper is to assess the mental health system in Brazil in relation to the human resources and the services available to the population.</p> <p>Methods</p> <p>The World Health Organization Assess...

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Main Authors: Razzouk Denise, Goihman Samuel, Gerolin Jeronimo, Barrett Thomas, Almeida-Filho Naomar, Delgado Pedro GG, Mari Jair J, Mateus Mario D, Rodriguez Jorge, Weber Renata, Andreoli Sergio B, Saxena Shekhar
Format: Article
Language:English
Published: BMC 2008-09-01
Series:International Journal of Mental Health Systems
Online Access:http://www.ijmhs.com/content/2/1/12
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author Razzouk Denise
Goihman Samuel
Gerolin Jeronimo
Barrett Thomas
Almeida-Filho Naomar
Delgado Pedro GG
Mari Jair J
Mateus Mario D
Rodriguez Jorge
Weber Renata
Andreoli Sergio B
Saxena Shekhar
author_facet Razzouk Denise
Goihman Samuel
Gerolin Jeronimo
Barrett Thomas
Almeida-Filho Naomar
Delgado Pedro GG
Mari Jair J
Mateus Mario D
Rodriguez Jorge
Weber Renata
Andreoli Sergio B
Saxena Shekhar
author_sort Razzouk Denise
collection DOAJ
description <p>Abstract</p> <p>Background</p> <p>The aim of this paper is to assess the mental health system in Brazil in relation to the human resources and the services available to the population.</p> <p>Methods</p> <p>The World Health Organization Assessment Instrument for Mental Health Systems (WHO AIMS) was recently applied in Brazil. This paper will analyse data on the following sections of the WHO-AIMS: a) mental health services; and b) human resources. In addition, two more national datasets will be used to complete the information provided by the WHO questionnaire: a) the Executive Bureau of the Department of Health (Datasus); and b) the National Register of Health Institutions (CNS).</p> <p>Results</p> <p>There are 6003 psychiatrists, 18,763 psychologists, 1985 social workers, 3119 nurses and 3589 occupational therapists working for the Unified Health System (SUS). At primary care level, there are 104,789 doctors, 184, 437 nurses and nurse technicians and 210,887 health agents.</p> <p>The number of psychiatrists is roughly 5 per 100,000 inhabitants in the Southeast region, and the Northeast region has less than 1 psychiatrist per 100,000 inhabitants. The number of psychiatric nurses is insufficient in all geographical areas, and psychologists outnumber other mental health professionals in all regions of the country. The rate of beds in psychiatric hospitals in the country is 27.17 beds per 100,000 inhabitants. The rate of patients in psychiatric hospitals is 119 per 100,000 inhabitants. The average length of stay in mental hospitals is 65.29 days. In June 2006, there were 848 Community Psychosocial Centers (CAPS) registered in Brazil, a ratio of 0.9 CAPS per 200,000 inhabitants, unequally distributed in the different geographical areas: the Northeast and the North regions having lower figures than the South and Southeast regions.</p> <p>Conclusion</p> <p>The country has opted for innovative services and programs, such as the expansion of Psychosocial Community Centers and the Return Home program to deinstitutionalize long-stay patients. However, services are unequally distributed across the regions of the country, and the growth of the elderly population, combined with an existing treatment gap is increasing the burden on mental health care. This gap may get even wider if funding does not increase and mental health services are not expanded in the country. There is not yet a good degree of integration between primary care and the mental health teams working at CAPS level, and it is necessary to train professionals to act as mental health planners and as managers. Research on service organization, policy and mental health systems evaluation are strongly recommended in the country. There are no firm data to show the impact of such policies in terms of community service cost-effectiveness and no tangible indicators to assess the results of these policies.</p>
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spelling doaj.art-3d6dd086b5654f96a4e607f153c1a5122022-12-21T18:34:54ZengBMCInternational Journal of Mental Health Systems1752-44582008-09-01211210.1186/1752-4458-2-12The mental health system in Brazil: Policies and future challengesRazzouk DeniseGoihman SamuelGerolin JeronimoBarrett ThomasAlmeida-Filho NaomarDelgado Pedro GGMari Jair JMateus Mario DRodriguez JorgeWeber RenataAndreoli Sergio BSaxena Shekhar<p>Abstract</p> <p>Background</p> <p>The aim of this paper is to assess the mental health system in Brazil in relation to the human resources and the services available to the population.</p> <p>Methods</p> <p>The World Health Organization Assessment Instrument for Mental Health Systems (WHO AIMS) was recently applied in Brazil. This paper will analyse data on the following sections of the WHO-AIMS: a) mental health services; and b) human resources. In addition, two more national datasets will be used to complete the information provided by the WHO questionnaire: a) the Executive Bureau of the Department of Health (Datasus); and b) the National Register of Health Institutions (CNS).</p> <p>Results</p> <p>There are 6003 psychiatrists, 18,763 psychologists, 1985 social workers, 3119 nurses and 3589 occupational therapists working for the Unified Health System (SUS). At primary care level, there are 104,789 doctors, 184, 437 nurses and nurse technicians and 210,887 health agents.</p> <p>The number of psychiatrists is roughly 5 per 100,000 inhabitants in the Southeast region, and the Northeast region has less than 1 psychiatrist per 100,000 inhabitants. The number of psychiatric nurses is insufficient in all geographical areas, and psychologists outnumber other mental health professionals in all regions of the country. The rate of beds in psychiatric hospitals in the country is 27.17 beds per 100,000 inhabitants. The rate of patients in psychiatric hospitals is 119 per 100,000 inhabitants. The average length of stay in mental hospitals is 65.29 days. In June 2006, there were 848 Community Psychosocial Centers (CAPS) registered in Brazil, a ratio of 0.9 CAPS per 200,000 inhabitants, unequally distributed in the different geographical areas: the Northeast and the North regions having lower figures than the South and Southeast regions.</p> <p>Conclusion</p> <p>The country has opted for innovative services and programs, such as the expansion of Psychosocial Community Centers and the Return Home program to deinstitutionalize long-stay patients. However, services are unequally distributed across the regions of the country, and the growth of the elderly population, combined with an existing treatment gap is increasing the burden on mental health care. This gap may get even wider if funding does not increase and mental health services are not expanded in the country. There is not yet a good degree of integration between primary care and the mental health teams working at CAPS level, and it is necessary to train professionals to act as mental health planners and as managers. Research on service organization, policy and mental health systems evaluation are strongly recommended in the country. There are no firm data to show the impact of such policies in terms of community service cost-effectiveness and no tangible indicators to assess the results of these policies.</p>http://www.ijmhs.com/content/2/1/12
spellingShingle Razzouk Denise
Goihman Samuel
Gerolin Jeronimo
Barrett Thomas
Almeida-Filho Naomar
Delgado Pedro GG
Mari Jair J
Mateus Mario D
Rodriguez Jorge
Weber Renata
Andreoli Sergio B
Saxena Shekhar
The mental health system in Brazil: Policies and future challenges
International Journal of Mental Health Systems
title The mental health system in Brazil: Policies and future challenges
title_full The mental health system in Brazil: Policies and future challenges
title_fullStr The mental health system in Brazil: Policies and future challenges
title_full_unstemmed The mental health system in Brazil: Policies and future challenges
title_short The mental health system in Brazil: Policies and future challenges
title_sort mental health system in brazil policies and future challenges
url http://www.ijmhs.com/content/2/1/12
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