Updating the Portuguese Mental Health Plan: a Swot Analysis

Abstract

Over the past decades, the organisation and management of mental health services in Portugal underwent an evolution similar to that of other European countries, going from an initial psychiatric hospital-centred phase, gradually establishing integration with primary healthcare, to the adoption of the current model, based on the principles of community psychiatry. To assess the implementation of the Mental Health Plan 2007-2016 in Portugal trough the perspective of the involved stakeholders. A SWOT analysis was carried out by professionals working at public, private and social institutions in mainland Portugal. Participants focused on structural reforms and on the identification of barriers to implementation. The SWOT analysis showed (in short summary): Strengths - Plan based on solid scientific and epidemiological grounds, collaboration with social sector; Weaknesses - Lack of dedicated task force, budget allocation; Opportunities - Integration with other health reforms, link with primary care, link with WHO, participation in the EU Joint Action; Threats - Stigma, reduced autonomy, political priorities. Notwithstanding multiple efforts, some issues remain unresolved and pose powerful and persistent challenges to the advancement of mental health care in Portugal. These include problems related to a funding system that encourages institutionalisation and rejects the promotion of care provided within the community, as well as those resulting from a management model for mental health services that continues to hamper the rational and responsible management of existing resources.