scholarly journals Primary care registration of the mental health needs of patients treated at outpatient specialized services: results from a medium-sized city in Brazil

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Carlos Alberto dos Santos Treichel ◽  
Ioannis Bakolis ◽  
Rosana Teresa Onocko-Campos

Abstract Background Although matrix support seeks to promote integrating Primary Care with specialized mental health services in Brazil, little is known about the quantitative impact of this strategy on sharing cases between different levels of care. The aim of this study was to investigate the prevalence and factors associated with Primary Care registration of the mental health needs of patients treated at outpatient specialized services in a medium-sized city in Brazil with recent implementation of matrix support. Methods This is a document-based cross-sectional study conducted through an analysis of 1198 patients’ medical records. Crude and adjusted associations with the outcome were explored using logistic regression. Results The prevalence of cases registered in Primary Care was 40% (n = 479). Evidence was found for associations between the outcome and the patients being over 30 years old, and referral by emergency or hospital services. There was conversely an inverse association between the outcome and status as a patient from the Outpatient Clinic or from the Psychosocial Care Center for psychoactive substance misuse. Conclusions Even with the provision of mechanisms for network integration, such as matrix support, our results suggest that more groundwork is necessary to ensure that sharing cases between Primary Care and specialized services is effective.

2021 ◽  
Author(s):  
Carlos Alberto dos Santos Treichel ◽  
Ioannis Bakolis ◽  
Rosana Teresa Onocko Campos

Abstract Background Although matrix support seeks to promote the integration of Primary Care with specialized mental health services in Brazil, little is known about the quantitative impact of this strategy on the sharing of cases between different levels of care. The aim of this study was to investigate the prevalence and factors associated with knowledge by Primary Care of mental health patients treated at outpatient specialized services in a medium-sized city in Brazil with recent implementation of matrix support. Methods This is a document-based cross-sectional study, conducted through the analysis of 1198 patients’ medical records. Crude and adjusted associations with the outcome were explored using logistic regression. Results The prevalence of cases known by Primary Care was 40% (n = 479). Evidence was found for associations between the outcome and the patients being over 30 years old, and referral by emergency or hospital services. There was, conversely, an inverse association between the outcome and status as a patient from the Outpatient Clinic or from the Psychosocial Care Center for psychoactive substance misuse. Conclusions Even with the provision of mechanisms for network integration, such as matrix support, our results suggest that more groundwork is necessary to ensure that the sharing of cases between Primary Care and specialized services is effective.


2015 ◽  
Vol 23 (6) ◽  
pp. 1173-1180 ◽  
Author(s):  
Heloísa Garcia Claro ◽  
Márcia Aparecida Ferreira de Oliveira ◽  
Janet C. Titus ◽  
Ivan Filipe de Almeida Lopes Fernandes ◽  
Paula Hayasi Pinho ◽  
...  

Objective: to investigate the correlation between disorders related to the use of alcohol and other drugs and symptoms of mental disorders, problems related to crime and violence and to age and gender. Methods: cross-sectional descriptive study carried out with 128 users of a Psychosocial Care Center for Alcohol and other Drugs, in the city of São Paulo, interviewed by means of the instrument entitled Global Appraisal of Individual Needs - Short Screener. Univariate and multiple linear regression models were used to verify the correlation between the variables. Results: using univariate regression models, internalizing and externalizing symptoms and problems related to crime/violence proved significant and were included in the multiple model, in which only the internalizing symptoms and problems related to crime and violence remained significant. Conclusions: there is a correlation between the severity of problems related to alcohol use and severity of mental health symptoms and crime and violence in the study sample. The results emphasize the need for an interdisciplinary and intersectional character of attention to users of alcohol and other drugs, since they live in a socially vulnerable environment.


2020 ◽  
Vol 14 ◽  
Author(s):  
Vanessa Ferreira de Almeida Piuchi ◽  
Claudia Barleta ◽  
Juliana Monte Real

Objetivo: analisar a violência de gênero sofrida pelas mulheres usuárias do Centro de Atenção Psicossocial Álcool e Drogas. Método: trata-se de um estudo quantitativo, descritivo, de corte transversal, com 30 mulheres atendidas pelo CAPS AD, que estavam ativas no sistema Registro das Ações Ambulatoriais de Saúde e responderam a um questionário estruturado. Analisaram-se os dados empregando a estatística não paramétrica. Resultados: apresenta-se, pelas mulheres pesquisadas, índice de violência elevada em relação à média nacional. Detalha-se que os fatores que apareceram como agravantes foram raça/cor, escolaridade e moradia, as maiores vítimas: mulheres negras e de escolaridade baixa. Conclusão: agrava-se, pelos fatores sociais, a violência praticada contra as mulheres pesquisadas. Mostra-se, para os agravantes, a necessidade de se incluir discussões nas políticas de combate à violência. Revela-se que o número de denúncia é baixo, assim como a procura por serviços de saúde. Descritores: Violência de Gênero; Saúde mental; Uso de Drogas; CAPS AD; Saúde Pública; Violência contra Mulheres.AbstractObjective: to analyze the gender violence suffered by women, users of the Psychosocial Care Center for Alcohol and Drugs. Method: this is a quantitative, descriptive, cross-sectional study of 30 women treated at CAPS AD, who were active in the Outpatient Health Actions Registry system and answered a structured questionnaire. Data was analyzed using nonparametric statistics. Results: the surveyed women presented a high level of violence in relation to the national average. It is noted that the factors that appeared as aggravating factors were race / color, education and housing, the biggest victims: black women and low education. Conclusion: the violence against women surveyed is aggravated by social factors. For the aggravating factors, the need to include discussions in the policies to combat violence is shown. The number of complaints is low, as is the demand for health services. Descriptors: Gender Violence; Mental Health; Drug Use; CAPS AD; Public Health; Violence Against Women.ResumenObjetivo: analizar la violencia de género que sufren las mujeres usuarias del Centro de Atención Psicosocial de Alcohol y Drogas. Método: este es un estudio cuantitativo, descriptivo, transversal con 30 mujeres atendidas por CAPS AD, que estaban activas en el sistema de Registro de Acciones de Salud Ambulatoria y respondieron un cuestionario estructurado. Los datos se analizaron mediante la estadística no paramétrica. Resultados: las mujeres encuestadas presentaron un alto nivel de violencia en relación con el promedio nacional. Cabe señalar que los factores que aparecieron como factores agravantes fueron la raza / color, la educación y la vivienda, las principales víctimas: las mujeres negras y de baja educación. Conclusión: la violencia contra las mujeres encuestadas se ve agravada por factores sociales. Para los factores agravantes, se muestra la necesidad de incluir discusiones en las políticas para combatir la violencia. El número de quejas es bajo, al igual que la demanda de servicios de salud. Descriptores: Violencia de Género; Salud Mental; Uso de Drogas; CAPS AD; Salud Pública; Violencia Contra la Mujer.


Author(s):  
Dandara Almeida Reis da Almeida Reis da Silva ◽  
Ludmila Santana de Almeida ◽  
Livia Lugarinho Correa ◽  
Rodrigo Fernandes Weyll Pimentel ◽  
Antonio Marcos Tosoli Gomes ◽  
...  

Background: Metabolic syndrome (MS) is associated with a greater risk of morbimortality. Ob-jective: To estimate the prevalence of Metabolic Syndrome (MS) and associated factors in patients of a Psychosocial Care Center (CAPS) in the city of Salvador, state of Bahia, Brazil. Method: Cross-sectional study set at CAPS in the city of Salvador-Bahia, between August 2019 and February 2020. MS was evaluated according to the National Cholesterol Education Program's Adult Treatment Panel III. In addition to descriptive statistics, gross and adjusted prevalence ratios were described. Results: MS was found in 100 (35.2%) individuals, 116 (40.9%) were obese and 165 (58.1%) had increased waist circumference. Polypharmacy was identified in 63 (22.3%) patients and 243 (85.9%) used antipsychotics. In the gross evaluation, the female (PR = 1.88; 95% CI: 1.35-2.63) and the use of antidepressants (PR = 1.41; 95%CI: 1.05-1.88) were associated with MS. After logistic re-gression, depression (PR = 1.86; 95%CI: 1.38-2.51), acanthosis (PR = 1.50; 95%CI: 1.18 - 1.90), use of antipsychotics (PR = 1.88; 95%CI: 1.13 - 2.75) and the hypertriglyceremic waist (PR = 3.33; 95%CI: 2.48- 4.46) were associated with MS. Conclusion: The prevalence of MS alerts to multimorbidity among individuals with mental disorders and the need for clinical screening.


2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Eva Rens ◽  
Geert Dom ◽  
Roy Remmen ◽  
Joris Michielsen ◽  
Kris Van den Broeck

Abstract Background An unmet mental health need exists when someone has a mental health problem but doesn’t receive formal care, or when the care received is insufficient or inadequate. Epidemiological research has identified both structural and attitudinal barriers to care which lead to unmet mental health needs, but reviewed literature has shown gaps in qualitative research on unmet mental health needs. This study aimed to explore unmet mental health needs in the general population from the perspective of professionals working with vulnerable groups. Methods Four focus group discussions and two interviews with 34 participants were conducted from October 2019 to January 2020. Participants’ professional backgrounds encompassed social work, mental health care and primary care in one rural and one urban primary care zone in Antwerp, Belgium. A topic guide was used to prompt discussions about which groups have high unmet mental health needs and why. Transcripts were coded using thematic analysis. Results Five themes emerged, which are subdivided in several subthemes: (1) socio-demographic determinants and disorder characteristics associated with unmet mental health needs; (2) demand-side barriers; (3) supply-side barriers; (4) consequences of unmet mental health needs; and (5) suggested improvements for meeting unmet mental health needs. Conclusions Findings of epidemiological research were largely corroborated. Some additional groups with high unmet needs were identified. Professionals argued that they are often confronted with cases which are too complex for regular psychiatric care and highlighted the problem of care avoidance. Important system-level factors include waiting times of subsidized services and cost of non-subsidized services. Feelings of burden and powerlessness are common among professionals who are often confronted with unmet needs. Professionals discussed future directions for an equitable mental health care provision, which should be accessible and targeted at those in the greatest need. Further research is needed to include the patients’ perspective of unmet mental health needs.


2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Till J. Bugaj ◽  
Katja Krug ◽  
Annalena Rentschler ◽  
Christoph Nikendei ◽  
Joachim Szecsenyi ◽  
...  

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