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Introduction: The Brazilian psychiatric reform has revolutionized the way that mental health care is provided all over the country, introducing the Psychosocial Care Centers (CAPS) and encouraging care at liberty. The CAPS have been assigned many objectives, such as prevention of hospitalizations and intervention in crises or suicide. This paper aims to describe the correlation between the implementation of CAPS and the rates of psychiatric hospitalizations and suicides from 2008 to 2018. Methods: This study has an ecological time series design and included residents of the city of Porto Alegre, RS, Brazil, who were hospitalized through the Sistema Único de Saúde (SUS). The data were obtained from official databases (DATASUS, CNES, and IBGE) and indicators were calculated (CAPS coverage, hospitalization rate, and suicide rate). Associations between the indicators were tested using Pearson's correlation coefficients. Results: We found a negative correlation between provision of CAPS and psychiatric hospitalizations (r = -0.607 p = 0.048). Conclusion: These results support the hypothesis that there is a negative correlation between implementation of the CAPS and psychiatric hospitalizations. This reinforces the importance of implementing policies related to improving psychiatric reform. [ABSTRACT FROM AUTHOR]

This paper analyzes ten recovery narratives of people with a serious mental illness who received mental health services in the public health care system of the city of Campinas, Brazil. We describe the person's recovery process and their relationship with the clinical services they received. This is a very needed conversation because the incorporation of recovery and recovering citizenship concepts in clinical practice are still incipient in South America. Most importantly, this research adds to the dialogue around recovering citizenship in different cultures. Methods: We used phenomenological methodology to interpret data drawn from the participant's life course interview (using the McGill Illness Narrative Interview). Results: We found that a) Before receiving services, people were overwhelmed by symptoms, but did not know what was going on; b) Loved ones and clinicians explained symptoms as part of a mental illness, and the proposed treatment was largely accepted; c) Mental health treatment was seen as helpful but not enough to address what was meaningful for their lives; d) People regained a life in their community, they felt proud of their recovery process, and solidarity and collectivism seemed to play important roles in their recovery process. Discussion: We identified similarities and differences in the recovery process of people with serious mental illness receiving public mental health services in Campinas, Brazil, when compared to the international literature. Receiving mental health services was very helpful for participants, principally when feeling overwhelmed by symptoms. Mental health services seemed to be less effective in helping people regain a meaningful life in their communities. Solidarity from friends and family members was recognized as an important recovery asset. [ABSTRACT FROM AUTHOR]

Several Latin American countries have made remarkable strides towards offering community mental health care for people with psychoses. Nonetheless, mental health clinics generally have a very limited outreach in the community, tending to have weaker links to primary health care; rarely engaging patients in providing care; and usually not providing recovery-oriented services. This paper describes a pilot randomized controlled trial (RCT) of Critical Time Intervention-Task Shifting (CTI-TS) aimed at addressing such limitations. The pilot RCT was conducted in Santiago (Chile) and Rio de Janeiro (Brazil). We included 110 people with psychosis in the study, who were recruited at the time of entry into community mental health clinics. Trial participants were randomly divided into CTI-TS intervention and usual care. Those allocated to the intervention group received usual care and, in addition, CTI-TS services over a 9-month period. Primary outcomes include quality of life (WHO Quality of Life Scale - Brief Version) and unmet needs (Camberwell Assessment of Needs) at the 18-month follow-up. Primary outcomes at 18 months will be analyzed by Generalized Estimating Equations (GEE), with observations clustered within sites. We will use three-level multilevel models to examine time trends on the primary outcomes. Similar procedures will be used for analyzing secondary outcomes. Our hope is that this trial provides a foundation for planning a large-scale multi-site RCT to establish the efficacy of recovery-oriented interventions such as CTI-TS in Latin America.

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Copyright of SMAD Revista Electronica Salud Mental, Alcohol y Drogas is the property of Universidade de Sao Paulo, Escola de Enfermagem de Ribeirao Preto and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Although matrix support seeks to promote integrating Primary Care with specialized mental health services in Brazil, little is known about the quantitative impact of this strategy on sharing cases between different levels of care. The aim of this study was to investigate the prevalence and factors associated with Primary Care registration of the mental health needs of 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 an analysis of 1198 patients' medical records. Crude and adjusted associations with the outcome were explored using logistic regression.Results: The prevalence of cases registered in 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 sharing cases between Primary Care and specialized services is effective. [ABSTRACT FROM AUTHOR]

Copyright of Salud Colectiva is the property of Instituto de Salud Colectiva Universidad Nacional de Lanus and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)