When psychiatry goes to school: a qualitative study on the increase of psychiatric care in middle schools in the state of São Paulo, Brazil

Abstract

Introduction: Brazilian education follows an inclusion model of special education and utilizes school-based mental health centers, leading to the medicalization of student concerns and raising questions about the link between schooling and children’s psychopathology. How do professionals in the education sector define their roles regarding students’ mental health? Methods: Twenty-one semi-directive interviews were conducted between March and June 2018 in five schools and two universities in the state of Sao Paulo, Brazil. Transcripts were analyzed using a grounded theory approach. Results: We identified three overarching domains: 1) a reported increase in the number of students with a psychiatric diagnosis, 2) teachers’ discourse on the influence of inclusive education policies on their daily practice, and 3) how socioeconomic differences drive selective medicalization of student concerns. Conclusion: In Brazil, selective medicalization has evolved differently in the public and private school systems, reinforcing inequalities already present in care and education.