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Systematic review of pathways to mental health care in Brazil: narrative synthesis of quantitative and qualitative studies

BACKGROUND: Pathways to care are actions and strategies employed by individuals in order to get help for health-related distress and the related processes of care providers. On several systematic reviews regarding pathways to mental health care (PMHC), studies regarding South American countries were...

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Autores principales: Amaral, Carlos Eduardo, Onocko-Campos, Rosana, de Oliveira, Pedro Renan Santos, Pereira, Mariana Barbosa, Ricci, Éllen Cristina, Pequeno, Mayrá Lobato, Emerich, Bruno, dos Santos, Roseléia Carneiro, Thornicroft, Graham
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6208112/
https://www.ncbi.nlm.nih.gov/pubmed/30450125
http://dx.doi.org/10.1186/s13033-018-0237-8
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author Amaral, Carlos Eduardo
Onocko-Campos, Rosana
de Oliveira, Pedro Renan Santos
Pereira, Mariana Barbosa
Ricci, Éllen Cristina
Pequeno, Mayrá Lobato
Emerich, Bruno
dos Santos, Roseléia Carneiro
Thornicroft, Graham
author_facet Amaral, Carlos Eduardo
Onocko-Campos, Rosana
de Oliveira, Pedro Renan Santos
Pereira, Mariana Barbosa
Ricci, Éllen Cristina
Pequeno, Mayrá Lobato
Emerich, Bruno
dos Santos, Roseléia Carneiro
Thornicroft, Graham
author_sort Amaral, Carlos Eduardo
collection PubMed
description BACKGROUND: Pathways to care are actions and strategies employed by individuals in order to get help for health-related distress and the related processes of care providers. On several systematic reviews regarding pathways to mental health care (PMHC), studies regarding South American countries were not present. This review synthesizes qualitative and quantitative research about PMHC in Brazil. METHODS: LILACS, MEDLINE and SCIELO databases were searched for papers regarding PMHC in Brazil. The results were organized in pathway stages, based on Goldberg and Huxley’s ‘model of Levels and Filters’ and on Kleinman’s framework of ‘Popular, Folk and Professional health sectors’. Analysis also considered the changes in national mental health policy over time. RESULTS: 25 papers were found, with data ranging from 1989 to 2013. Complex social networks were involved in the initial recognition of MH issues. The preferred points of first contact also varied with the nature and severity of problems. A high proportion of patients is treated in specialized services, including mild cases. There is limited capacity of primary care professionals to identify and treat MH problems, with some improvement from collaborative care in the more recent years. The model for crisis management and acute care remains unclear: scarce evidence was found over the different arrangements used, mostly stressing lack of integration between emergency, hospital and community services and fragile continuity of care. CONCLUSIONS: The performance of primary care and the regulation of acute demands, especially crisis management, are the most critical aspects on PMHC. Although primary care performance seems to be improving, the balanced provision and integration between services for adequate acute and long-term care is yet to be achieved. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s13033-018-0237-8) contains supplementary material, which is available to authorized users.
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spelling pubmed-62081122018-11-16 Systematic review of pathways to mental health care in Brazil: narrative synthesis of quantitative and qualitative studies Amaral, Carlos Eduardo Onocko-Campos, Rosana de Oliveira, Pedro Renan Santos Pereira, Mariana Barbosa Ricci, Éllen Cristina Pequeno, Mayrá Lobato Emerich, Bruno dos Santos, Roseléia Carneiro Thornicroft, Graham Int J Ment Health Syst Review BACKGROUND: Pathways to care are actions and strategies employed by individuals in order to get help for health-related distress and the related processes of care providers. On several systematic reviews regarding pathways to mental health care (PMHC), studies regarding South American countries were not present. This review synthesizes qualitative and quantitative research about PMHC in Brazil. METHODS: LILACS, MEDLINE and SCIELO databases were searched for papers regarding PMHC in Brazil. The results were organized in pathway stages, based on Goldberg and Huxley’s ‘model of Levels and Filters’ and on Kleinman’s framework of ‘Popular, Folk and Professional health sectors’. Analysis also considered the changes in national mental health policy over time. RESULTS: 25 papers were found, with data ranging from 1989 to 2013. Complex social networks were involved in the initial recognition of MH issues. The preferred points of first contact also varied with the nature and severity of problems. A high proportion of patients is treated in specialized services, including mild cases. There is limited capacity of primary care professionals to identify and treat MH problems, with some improvement from collaborative care in the more recent years. The model for crisis management and acute care remains unclear: scarce evidence was found over the different arrangements used, mostly stressing lack of integration between emergency, hospital and community services and fragile continuity of care. CONCLUSIONS: The performance of primary care and the regulation of acute demands, especially crisis management, are the most critical aspects on PMHC. Although primary care performance seems to be improving, the balanced provision and integration between services for adequate acute and long-term care is yet to be achieved. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s13033-018-0237-8) contains supplementary material, which is available to authorized users. BioMed Central 2018-10-31 /pmc/articles/PMC6208112/ /pubmed/30450125 http://dx.doi.org/10.1186/s13033-018-0237-8 Text en © The Author(s) 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Review
Amaral, Carlos Eduardo
Onocko-Campos, Rosana
de Oliveira, Pedro Renan Santos
Pereira, Mariana Barbosa
Ricci, Éllen Cristina
Pequeno, Mayrá Lobato
Emerich, Bruno
dos Santos, Roseléia Carneiro
Thornicroft, Graham
Systematic review of pathways to mental health care in Brazil: narrative synthesis of quantitative and qualitative studies
title Systematic review of pathways to mental health care in Brazil: narrative synthesis of quantitative and qualitative studies
title_full Systematic review of pathways to mental health care in Brazil: narrative synthesis of quantitative and qualitative studies
title_fullStr Systematic review of pathways to mental health care in Brazil: narrative synthesis of quantitative and qualitative studies
title_full_unstemmed Systematic review of pathways to mental health care in Brazil: narrative synthesis of quantitative and qualitative studies
title_short Systematic review of pathways to mental health care in Brazil: narrative synthesis of quantitative and qualitative studies
title_sort systematic review of pathways to mental health care in brazil: narrative synthesis of quantitative and qualitative studies
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6208112/
https://www.ncbi.nlm.nih.gov/pubmed/30450125
http://dx.doi.org/10.1186/s13033-018-0237-8
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