Document Detail


Shortage and underutilization of psychiatric beds in southern Brazil: independent data of Brazilian mental health reform.
MedLine Citation:
PMID:  20300728     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: Mental health policies throughout the world are being subjected to several changes due to increased pressure from the public and from health administrators. Mental health policies in the developing world experienced changes following advice and consultation from the World Health Organization (WHO). This was the case with Brazil, which enacted several laws and policies affecting community care and the closure of beds in psychiatric hospitals (the deinstitutionalization movement). Rio Grande do Sul, the southeast state in Brazil, adopted this policy in 1992, but still suffers from a shortage of psychiatric beds in both general hospitals (GHs) and psychiatric hospitals (PHs), despite advances in the provision of community care. As a result, Rio Grande do Sul (RS) can be studied as an example of "what actually happens" in mental health care in the developing world.
METHODS: The study analyzed online administrative data from 2000 to 2007 for three main parameters of mental health care (i.e. hospital use rate, length of stay, and hospital bed capacity). These were used to evaluate differences in psychiatric care among GHs and PHs. The number of existing and required psychiatric beds in RS was also calculated.
RESULTS: GHs had very low hospital use rates, while PHs had a very high length of stay (200% higher than GH). The number of admissions to GHs grew by 170% over the 8 year period, and psychiatric bed availability was 1.5 per 10,000 inhabitants.
CONCLUSIONS: The study provided evidence for the need of 30-50% more psychiatric beds in GHs. Also, additional staff training is needed to increase use rates in GHs and decrease the length of stay in PHs. Additional studies covering national data must be carried out to assess the extent of these problem in other Brazilian mental health care services.
Authors:
Rafael Henriques Candiago; Sergio da Silva Saraiva; Veralice Gonçalves; Paulo Belmonte-de-Abreu
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Publication Detail:
Type:  Journal Article     Date:  2010-03-19
Journal Detail:
Title:  Social psychiatry and psychiatric epidemiology     Volume:  46     ISSN:  1433-9285     ISO Abbreviation:  Soc Psychiatry Psychiatr Epidemiol     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-04-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8804358     Medline TA:  Soc Psychiatry Psychiatr Epidemiol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  425-9     Citation Subset:  IM    
Affiliation:
Programa de Pós-Graduação em Ciências, Médicas: Psiquiatria, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil, rcandiago@gmail.com.
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