Background: The aim of this paper is to assess the mental health system in Brazil in relation to the human resources and the services available to the population.
The objective of the present survey was to assess the Brazilian scientific production in psychiatry, psychobiology, and mental health during the 1998-2002 period. The universities' graduate programs concentrate the vast majority of the scientific production in Brazil. We assessed the annual reports from the graduate programs to the Brazilian Ministry of Education concerning master's and doctoral theses and the articles published in journals indexed by the Institute of Scientific Information (ISI). There are nine Master's and Doctoral graduate programs dedicated to research in psychiatry, neuropsychiatry, psychobiology, and mental health in the country, seven being located in southern states. During the 5-year period, from 1998 to 2002, 186 students received their doctorate degree (37/year). The programs published 637 articles in journals indexed by ISI, the majority of them in journals with an impact factor higher than 2. The research advisors' productivity varied among graduate programs, ranging from 0.6 to 2.0 articles per year in ISI-indexed journals. Despite the substantial barriers faced by the Brazilian scientific community (mainly financial and writing difficulties), Brazil's scientific mental health production is on the rise. The number of articles published in ISI-indexed journals has doubled without a significant increase in the number of graduate theses, suggesting that there was an improvement in both the quality of the scientific production and the productivity of the graduate programs. Based on these data, it is reasonable to predict a tendency to an increase in production over the next few years.
This priority-setting research exercise highlighted a need for implementing investments at the primary-care level, particularly in the family health program; the urgent need to evaluate services; and policies to improve equity by increasing accessibility to services and testing interventions to reduce barriers for seeking mental health treatment.
Brazilian scientific output exhibited a 4-fold increase in the last two decades because of the stability of the investment in research and development activities and of changes in the policies of the main funding agencies. Most of this production is concentrated in public universities and research institutes located in the richest part of the country. Among all areas of knowledge, the most productive are Health and Biological Sciences. During the 1998-2002 period these areas presented heterogeneous growth ranging from 4.5% (Pharmacology) to 191% (Psychiatry), with a median growth rate of 47.2%. In order to identify and rank the 20 most prolific institutions in these areas, searches were made in three databases (DataCAPES, ISI and MEDLINE) which permitted the identification of 109,507 original articles produced by the 592 Graduate Programs in Health and Biological Sciences offered by 118 public universities and research institutes. The 20 most productive centers, ranked according to the total number of ISI-indexed articles published during the 1998-2003 period, produced 78.7% of the papers in these areas and are strongly concentrated in the Southern part of the country, mainly in São Paulo State. Correspondence
A b s t r a c t Objective: The prevalence and burden of mental disorders have been growing in Latin-American and the Caribbean countries and research is an important tool for changing this scenario. The objective of this paper is to describe the development of mental health research in Latin American and the Caribbean countries from 1995 to 2005. Method: The indicators of productivity were based on the ISI Essential Science Indicators database. We compared the number of papers and citations, as well as the number of citations per paper between 1995 and 2005 for each country ranked in the Essential Science Indicators. Result: Eleven LatinAmerican countries were ranked in the ISI database and six of them demonstrated a higher level of development in mental health research: Argentina, Brazil, Chile, Colombia, Mexico, and Venezuela. Mexico produced the largest number of papers, while Brazil showed a larger number of citations per paper. Conclusion: Mental health research is still incipient in Latin American and the Caribbean countries, and many challenges remain to be overcome. Also, it is necessary to establish the research priorities, to allocate more funding, and to improve researchers training in research method and design.Descriptors: Latin America; Mental health; Research; Science, technology and society; Psychiatry Resumo Objetivo: A prevalência e a carga dos transtornos mentais vêm crescendo nos países latino-americanos e a pesquisa tem sido considerada uma importante ferramenta para alterar este cenário. Este estudo descreve o desenvolvimento da pesquisa em saúde mental nos países latino-americanos e Caribe no período de 1995 a 2005. Método: Foram utilizados os indicadores de produtividade baseados no banco de dados "Essential Science Indicators" do ISI. Foram comparados o número total de artigos e citações e também o número de citações por artigo para cada um dos países classificados no Essential Science Indicators. Resultados: Foram encontrados 11 países latino-americanos e Caribe no ISI, e seis destes apresentaram um maior desenvolvimento em pesquisa em saúde mental: Argentina, Brasil, Chile, Colômbia, México e Venezuela. O México foi o que apresentou o maior número de artigos, enquanto o Brasil apresentou maior número de citações por artigo. Conclusão: A pesquisa em saúde mental nos países latinoamericanos e Caribe ainda é incipiente e muitos desafios necessitam ser superados, como o estabelecimento de prioridades, maior alocação de fundos e aprimoramento do treinamento dos pesquisadores em metodologia e desenhos de pesquisa.
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