Organization of mental health services to face COVID-19 in Brazil

Abstract

Issue/problem Covid-19 pandemic requires rapid responses. The reconfiguration of the psychosocial care network was needed to ensure access to all patients during this period. Description of the problem Psychosocial Care Centers (PCC) are strategic equipment for strengthening the mental health policy in Brazil. These services work with a multi and interdisciplinary team, aiming to assist crisis and rehabilitation processes of people with severe and persistent mental disorders or those with impairments due to the use of psychoactive substances. This work shares the experience of two PCC over the COVID-19 pandemic in São Paulo, Brazil. In April 2020, in front of the increasing Covid-19 cases and hospitalization, lack of hospital beds for mental health care, suspension of PCC group activities, and restriction of face-to-face assistance, it was necessary to adjust the PCC work process and physical structure. Results Telemedicine was implemented to assure assistance and monitoring. An internal flow was implemented to identify and assess patients seeking the service with respiratory symptoms and proceed with case notification if confirmed. A station for respiratory symptoms screening was settled outside the PCC, an isolation room to symptomatic respiratory patients was defined to medical assessment, and referral criteria to the emergency care established. To reinforce beds for hospitals in the region, inpatient beds were created in the PCC to attend hospitalization of acute crisis cases. Further, professionals from Primary Health Care were relocated and trained to support PCC assistance. Lessons This experience reaffirms the role of PCC as an articulator of the psychosocial network. Reorganization of PCC work process enabled the continuity of mental health outpatient care as well as rearguard from inpatient beds. Key messages The COVID-19 pandemic reinforce the necessity of integrated healthcare networks to provide care access and continuity of care. This experience reaffirms the role of PCC as an articulator of the psychosocial network.

Governance in mental healthcare policies during the COVID-19 pandemic in Mexico

“…Concerning mental healthcare strategies, as reported in the literature, they were more focused on clinical care in the context of the pandemic, i.e., for the population presenting symptoms associated with lockdown and social distancing ( 40 – 42 ), while healthcare services for people with specific MD decreased during the pandemic. Healthcare institutions found it necessary to reduce inpatient and outpatient care processes to implement processes for the detection, monitoring and surveillance of COVID-19 cases.…”

“…Furthermore, those most in need of mental healthcare are those whose livelihoods have been made even more precarious because of social disparities, in turn, few of them will seek help because their basic needs are not met by the mental healthcare systems ( 9 ). In contrast, a study in Brazil reported that, the reorganization of healthcare services integrating mental care is necessary to provide care access and continuity of care for people with MD ( 42 ).…”