Atuação dos Centros de Atenção Psicossocial em quatro centros urbanos no Brasil

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, São 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.