The impact of mental health workshops for community physicians in increasing access to Mental Health Care in a Brazilian primary care setting

• Autor(a) principal: Oliveira, Maria Helena Pereira Pires de
• Data de Publicação: 2020
• Tipo de documento: Dissertação
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: http://hdl.handle.net/10362/98118
• topic: Mental health gap; Primary care; Collaborative care; Workshops; Referrals; Access; Ciências Médicas

ABSTRACT: Background: Many individuals with mental health disorders remain untreated although effective treatment exists. This is known as the mental health gap. The gap is particularly wide in low and middle income countries, such as Brazil. One of the strategies suggested by the World Health Organization to reduce the gap, is to integrate mental health into primary care. A group of family physicians and psychiatrist created a collaborative care model, in Brasilia, Federal District, Brazil. A series of workshops were delivered to primary care doctors, covering depression, anxiety, psychosis and substance misuse. Objective: To measure mental health referrals from primary to secondary care the year before the beginning of these workshops, and the year after, including the months in which the workshops took place. Method: An observational longitudinal study was conducted, with monthly measures of referrals from primary care to secondary care psychiatry, between October 2017 and October 2019. Twenty physicians who enrolled in the workshops were included in the analysis. The control group consists of 20 physicians working in the same health district who did not attend the workshops. All tests were performed with 95% confidence. The tests applied to samples were: Shapiro-Wilk Normality Test, Wilcoxon Test for two samples and Kruskall Wallis test for comparison of several samples. Results: For those who attended the workshops at least twice, there was a statistically significant decline in referrals, with a P value of 0.04. There is a general trend toward increase in referrals for those who did not attend the workshops, although with no statistical significance, probably due to sample size. Conclusion: The workshops seem to be an interesting strategy to increase access to mental health in primary care, and reduce referrals to secondary care.