Community mental health care network: an evaluative approach in a Brazilian state

International Journal of Mental Health Systems

卷:17

Research

Mariana Arantes e Silva¹  Eliete Albano de Azevedo Guimarães¹  Denise Alves Guimarães¹  Carlos Alberto Pegolo da Gama¹  Leonardo Isolani e Andrade¹  Celina Maria Modena²  Vívian Andrade Araújo Coelho³ 

[1] Federal University of São João Del Rei, Mid-West Campus (UFSJ/CCO), Divinópolis, Minas Gerais, Brazil;

[2] Graduate Program in Public Health, René Rachou Institute/Fiocruz Minas, Belo Horizonte, Minas Gerais, Brazil;

[3] Graduate Program in Public Health, René Rachou Institute/Fiocruz Minas, Belo Horizonte, Minas Gerais, Brazil;Department of Family Medicine, Mental and Collective Health (DEMSC), Medical School, Federal University of Ouro Preto (UFOP), R. Dois - Campus Morro do Cruzeiro, 35400-000, Ouro Preto, MG, Brazil;

关键词: Mental health;    Community mental health services;    Health services research;    Health care quality;    Access and evaluation;   

DOI  :  10.1186/s13033-023-00578-7

 received in 2022-12-21, accepted in 2023-04-03,  发布年份 2023

来源: Springer

【 摘 要 】

In recent decades, public policies of the Unified Health System (SUS) in Brazil have structured a community mental health care network (RAPS) based on various community actions and services. This study carried out evaluative research on the implementation of the structure and process dimensions of this care network in Minas Gerais, the second most populous state of Brazil, generating indicators that can enhance the strategic management of the public health system in the strengthening the psychosocial care in the state. The application of a multidimensional instrument, previously validated (IMAI-RAPS), in 795 of the 853 municipalities in Minas Gerais was carried out between June and August 2020. Regarding the structural dimension, we noticed an adequate implementation of services like ‘Family Health Strategy,’ ‘Expanded Family Health Center,’ and ‘Psychosocial Care Centers’ but a lack of ‘Beds in General Hospitals’ destinated to mental health care, ‘Unified Electronic Medical Records’ and ‘Mental Health Training Activities for Professionals.’ In the process dimension, adequate implementation of actions such as ‘Multidisciplinary and Joint Care,’ ‘Assistance to Common Mental Disorders by Primary Health Care,’ ‘Management of Psychiatric Crises in Psychosocial Care Centers,’ ‘Offer of Health Promotion Actions,’ and ‘Discussion of Cases by Mental Health Teams’ point to a form of work consistent with the guidelines. However, we detected difficulties in the implementation of ‘Psychosocial Rehabilitation Actions,’ ‘Productive Inclusion,’ ‘User Protagonism,’ ‘Network Integration,’ and practical activities for the effectiveness of collaborative care. We found a better implementation of the mental health care network in more populous, demographically dense, and socioeconomically developed cities, which shows the importance of regional sharing of services that are not possible for small cities. The evaluation practices of mental health care networks are scarce throughout the Brazilian territory, a fact also found in Minas Gerais, highlighting the need for its expansion not only in the scientific sphere but also in the daily life of the various levels of management.

【 授权许可】

CC BY   
© The Author(s) 2023