Avaliação temporal dos modelos de cuidado em saúde mental no estado de Goiás (GO)

Abstract

Mental health care models have been revised since the second half of the 20th century, in Brazil and other countries, as part of the so-called psychiatric reform movements, which advocate reversing the logic of care centered on psychiatric hospitals to care in freedom, with a focus on guaranteeing human rights and community and territorial psychosocial care. The aim of this study was to evaluate the temporal trend of mental health care models in the state of Goiás (GO) over the last two decades. To this end, a time series study was carried out evaluating indicators of the community model (Care Coverage Index of the Psychosocial Care Network - iRAPS) and the hospital based model (Rate of specialized psychiatric beds per 100,000 inhabitants), from 2008 to 2019. The results showed an increase in the supply of Psychosocial Care Network (RAPS) devices - iRAPS increased from 0.10 in 2008 to 0.37 in 2019 - and a reduction in the coverage of psychiatric beds in specialized hospitals by the SUS - 17.7 beds per 100,000 inhabitants (2008) and 8.5 beds per 100,000 inhabitants (2019). The findings of this study show an uneven transition between the two models in the period analyzed. Despite the clear reduction in the supply of specialized psychiatric beds by the SUS, the increase in psychosocial care devices occurred slowly and heterogeneously between the state's health macro-regions. These findings reinforce the permanent and unfinished nature of the Brazilian psychiatric reform, especially in the state of Goiás, within the scope of the Unified Health System (SUS).