Integrated Care in the Mental Health Policy of the Brazilian and Portuguese Health Systems Integrated Care in the Mental Health Policy of the Brazilian and Portuguese Health Systems: comparative analysis

Abstract

Comprehensive and integrated care instigates the centrality of care in the person and promotes good results in the face of the varied health needs presented by the population, including demands related to mental health. The present work aims to investigate how comprehensive and integrated care is expressed in the mental health policies of the Portuguese National Health System and the Brazilian Unified Health System. Documentary, qualitative, and exploratory research was carried out to this. Sixteen documents were selected, including laws, decrees, ordinances, and plans from both countries and submitted to content analysis. The results are presented in three categories: deinstitutionalization, care networks, and the role of Primary Care in mental health care. Both countries invested in the deinstitutionalization of users and the promotion of care focused on the specific needs and conditions of individuals in extra-hospital services. There was an expansion of mental health care at the community level, integrating it with Primary Care and other services in the care networks. However, in recent years, setbacks have also been identified in the legislation of one of them. The risk of lack of assistance and the impacts of social isolation resulting from the COVID-19 pandemic imposed challenges for the implementation of comprehensive and integrated care. It is concluded that integrated care in the field of mental health has evolved in the legislation of both systems, following scientific evidence. New advances will depend on greater financial support for the expansion and qualification of networks. It is hoped that the findings presented can support future initiatives that contribute to overcoming the challenges.