Abstract
Brazil has a unique mental health care system, characterized by universal coverage delivered by interdisciplinary teams both in the community and in specialized centros de atenção psicossocial (CAPS—psychosocial care centers). Provision of patient-centered mental health care is an important principle of Brazilian mental health care, but this topic has not been well-studied. We analyzed data from a cross-sectional survey of 151 community health workers (CHWs), nurses, and physicians in Santa Luzia, Minas Gerais State, Brazil. Chi-squares, t-tests and multivariate regression analyses examined differences in socio-demographics, caseload, engagement in evidence-based practices (EBPs), and transdisciplinary collaboration between providers who reported providing high levels of patient-centered mental health care and those who did not. In multivariate regression models, components of transdisciplinary collaboration were significantly associated with providers’ perceptions of patient-centered mental health care (p < 0.05). CHWs were also significantly more likely to report providing patient-centered care than physicians and nurses. EBP engagement and sociodemographics were not associated with perceptions. Results suggest that training efforts to improve patient-centered mental health care in Brazil could build upon CHWs’ skills and focus on transdisciplinary collaboration. Findings may inform practice in other countries with similar health care systems.
Highlights
Data from the World Health Organization (WHO) indicate that mental health disorders account for 12% of the global burden of disease [1]
Mental health disorders appear to be prevalent in Brazil, a highly populous, diverse nation comprised of 26 states, one federal district and 5560 cities
Santa Luzia was selected for the mental health survey in part because they were one of the first municipalities in Brazil to devote substantial resources to mental health care and because the
Summary
Data from the World Health Organization (WHO) indicate that mental health disorders account for 12% of the global burden of disease [1]. Mental health disorders appear to be prevalent in Brazil, a highly populous, diverse nation comprised of 26 states, one federal district and 5560 cities. A recent representative cross-sectional household sample of 5037 adults in one of Brazil’s largest cities, São Paulo, found that 29.6% of respondents reported having a mental health disorders in the last 12 months [2]. Anxiety disorders were the most common condition (19.9%), followed by mood (11.0%), impulse-control (4.3%), and substance use (3.6%) disorders [2]. These prevalence rates are slightly higher than in the U.S (where 26.2% report mental health disorders in the last year) and about two. Public Health 2016, 13, 33; doi:10.3390/ijerph13010033 www.mdpi.com/journal/ijerph
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