A group of ten countries formed by the World Health Organization (WHO) to serve as a reference in mental health services include Brazil. The WHO selected countries that were able to increase psychiatric services to become part of a discussion group and offer their strategies as models for other regions to follow.
The action is part of a program launched by the WHO in 2008 to ensure treatment, within ten years, of the prevailing mental health conditions among populations, such as depression, schizophrenia, drug-related disorders, epilepsy, Alzheimer's, and mental health disorder among children.
These types of problems, according to the Mental Health coordinator of the Brazilian Ministry of Health, Pedro Gabriel, affect 12% to 15% of the world population. In Brazil, as of 2002, 21% of the population had access to treatment for those diseases, whereas the current rate is 57%.
What the government did was create Psychosocial Attention Centers (Caps) in municipalities located in the interior of the states. Caps units operate in tandem with the Family Health Program of the federal government and monitor the health of patients, but do not offer inpatient treatment. The number of beds in psychiatric hospitals, however, decreased from 59,000 in 2001 to 36,000 last year.
Pedro Gabriel gives the example of the municipality of Vera Cruz, in the state of Rio Grande do Norte, which has 19,000 inhabitants and in which a Caps was inaugurated a year ago. The premises count on with four college-educated and six high school-educated professionals, and have a total of 250 patients.
If needed, people will spend the day there, but no inpatient treatment takes place. The aim is for patients to integrate with society. There are currently 1,394 Caps, as against 424 in 2002. Alcohol and drug patients are being referred to general hospitals, because, according to the coordinator, they usually have physical health problems as well.
The WHO should summon all of the invited countries to a meeting in September or October this year. The strategies for operation will be outlined in further detail then. Besides Brazil, Egypt, South Africa, Italy and the Netherlands have also been invited by the organization. The WHO should invite nations in the near future.
All of the participating countries have expanded access to services, but each has done so following its own model. During a visit to Brazil, the director of Mental Health and Substance Abuse of the WHO, Benedetto Saraceno, said that the ethical and technical principles underlying the Brazilian psychiatric reform are on target. He highlighted the reduction of beds in asylums and the increased number of Caps.
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