The path to strengthening mental health care is in the SUS – 10/03/2023 – Public Health

Symptoms related to mental health impose suffering and can impact all aspects of a person’s life. In addition to the possible difficulty in identifying and communicating these symptoms due to the stigma and misinformation that still surround the topic, seeking help is especially challenging for the 150 million people who depend exclusively on the SUS to access healthcare.

Data published in Sheet show that 9 out of 10 municipalities have less than one psychologist in the SUS for every thousand inhabitants. Considering that more than 26 million Brazilians lived with symptoms of anxiety and depression even before the pandemic and since then the situation has worsened, the demand for specialized care has exploded and many people are unable to access it.

In 2019, 71% of people with symptoms compatible with depression in Brazil did not receive treatment. Data from the Mental Health Panorama, a recent study launched by the Cactus Institute, also reveals that 62% of respondents from a representative sample of all regions of the country do not access any type of mental health support service. It is therefore essential to think of a service model that addresses the needs of the population in an agile, effective and targeted manner.

One of the answers lies in the SUS itself, in the primary care network. The gateway to the health system, primary care is present in all Brazilian municipalities and its more than 52 thousand teams work close to their communities, knowing their challenges and vulnerabilities.

As with other health conditions, studies show that the chances of worsening disorders are lower and the chances of successful treatment are greater when detection and care interventions occur early. Therefore, strengthening and training these teams to identify, welcome and support people who are experiencing the first symptoms of mental suffering is a crucial alternative to democratize access to care and prevent worsening.

Research and initiatives in this sense are gaining ground in Brazil and around the world and show significant results, such as the project Empowerin Harvard, In the USA. In Brazil, ImpulsoGov, a non-profit organization that supports the management of the SUS in municipalities free of charge, began a pilot project in September to strengthen mental health care from SUS primary care in São Caetano do Sul, in Greater São Paulo .

The initiative will train network professionals, such as nurses and nursing technicians, to identify, track and offer primary mental health care for people with mild and moderate symptoms of depression. Each trained professional will carry out cycles of care for these cases based on a psychosocial support approach recommended by the WHO under the supervision of specialists. Without the intention of replacing the role of the specialist, the model aims to expand, unburden and qualify the care network offered to the population.

In a country where access to mental health care services is scarce and marked by inequalities based on race, class and region, strengthening initiatives in the wider SUS network emerges as a viable and scalable path to reducing the gap between demand and the provision of care and guaranteeing everyone’s right to comprehensive care.

Follow the initiatives of Institute for Health Policy Studies also on Instagram at @iepsoficial

Isabel Opice and Daniela Krausz, operations director and mental health project manager at ImpulsoGov, an NGO that supports municipal governments free of charge in the use of data and technology in the SUS; Maria Fernanda Quartiero and Mariana Rae, CEO and project coordinator at Instituto Cactus, a philanthropic entity dedicated to promoting mental health in Brazil.

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