Functioning of Psychosocial Care centers in four cities in Brazil/Atuacao dos Centros de Atencao Psicossocial em quatro centros urbanos no Brasil/Actuacion de los Centros de Atencion Psicosocial en cuatro centros urbanos en Brasil

• Published in: Revista panamericana de salud pública 2018-04, Vol.42 (1)
• Main Authors: Onocko-Campos, Rosana Teresa, Saraceno, Benedetto, Amaral, Carlos Eduardo Menezes, de Oliveira, Bruno Diniz Castro, Treichel, Carlos Alberto dos Santos, Delgado, Pedro Gabriel Godinho
• Format: Article
• Language: Spanish
• ISSN: 1020-4989

Objective. To describe the functioning of Psychosocial Care centers (CAPS) in four Brazilian cities. Methods. In this cross-sectional study (AcesSUS), 917 CAPS users were interviewed in the cities of Campinas, Sao Paulo, Porto Alegre, and Fortaleza. Only CAPS focused on severe mental disorders in adults were included, that is, CAPS focusing on substance abuse and on children and adolescents were excluded. Users answered a multiple choice questionnaire about their path from primary health care services until reaching the CAPS and hospital care in relation to mental health problems. Results. Care by a psychiatrist and use of medications were reported by 90.7% to 99.7% of CAPS users in association with multiprofessinal care and therapeutic groups. Access to medication was interrupted in the 6 months prior to the interview, especially in Fortaleza (70%) and Porto Alegre (50%). In all cities, less than 10% of users had a psychiatric hospital admission after treatment at the CAPS was started. Conclusions. The transition from a hospital-centered model to a community-based model is well under way in Brazil, with concrete achievements. However, there is heterogeneity among different care networks, which entails the need for contextualized analysis of each individual location, with identification of difficulties that prevent the adequate functioning of these care networks in the psychosocial paradigm. Keywords Mental health; deinstitutionalization; health policy; surveys and questionnaires; Brazil. Objetivo. Describir la actuacion de los Centros de Atencion Psicosocial (CAPS) en cuatro centros urbanos en Brasil. Metodos. Se realizo un estudio transversal (AcesSUS) por medio de una entrevista a 917 usuarios en seguimiento en los CAPS de Campinas, Sao Paulo, Porto Alegre y Fortaleza. Se incluyeron solo los tipos de CAPS donde se tratan trastornos mentales graves en adultos, con exclusion de los centrados en el uso de sustancias y servicios para ninos y adolescentes. Los usuarios respondieron a un cuestionario de opcion multiple sobre su recorrido entre los servicios de atencion primaria, los CAPS y los hospitales en relacion con los trastornos de salud mental. Resultados. Se notificaron servicios de atencion psiquiatrica y uso de medicamentos, junto con atencion multiprofesional y participacion en grupos terapeuticos, en una proporcion de 90,7% a 99,7% de los usuarios en seguimiento en los CAPS. El acceso a medicamentos se interrumpio en los 6 meses anteriores a la en