The mental health care model in Brazil: analyses of the funding, governance processes, and mechanisms of assessment

Abstract

OBJECTIVE: This study aims to analyze the current status of the mental health care modelof the Brazilian Unified Health System, according to its funding, governance processes, andmechanisms of assessment.METHODS: We have carried out a documentary analysis of the ordinances, technical reports,conference reports, normative resolutions, and decrees from 2009 to 2014.RESULTS: This is a time of consolidation of the psychosocial model, with expansion of the healthcare network and inversion of the funding for community services with a strong emphasis onthe area of crack cocaine and other drugs. Mental health is an underfunded area within thechronically underfunded Brazilian Unified Health System. The governance model constrainsthe progress of essential services, which creates the need for the incorporation of a process ofregionalization of the management. The mechanisms of assessment are not incorporated intothe health policy in the bureaucratic field.CONCLUSIONS: There is a need to expand the global funding of the area of health, specificallymental health, which has been shown to be a successful policy. The current focus of the policyseems to be archaic in relation to the precepts of the psychosocial model. Mechanisms ofassessment need to be expanded.