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(Reference retrieved automatically from Web of Science through information on FAPESP grant and its corresponding number as mentioned in the publication by the authors.)

Determinants of timely access to Specialized Mental Health Services and maintenance of a link with primary care: a cross-sectional study

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Author(s):
dos Santos Treichel, Carlos Alberto [1] ; Bakolis, Ioannis [2] ; Onocko-Campos, Rosana Teresa [1]
Total Authors: 3
Affiliation:
[1] Univ Estadual Campinas, Sch Med Sci, Dept Collect Hlth, 126 Cidade Univ Zeferino Vaz, BR-13083887 Campinas, SP - Brazil
[2] Kings Coll London, Inst Psychiat, Dept Biostat & Hlth Informat, Hlth Serv & Populat Res Dept, London - England
Total Affiliations: 2
Document type: Journal article
Source: INTERNATIONAL JOURNAL OF MENTAL HEALTH SYSTEMS; v. 15, n. 1 DEC 4 2021.
Web of Science Citations: 0
Abstract

Background Although access to specialized services is one of the main components of the study of paths to mental health care worldwide, the factors related to the continuity of the patient's link with Primary Care after admission to a Specialized Mental Health Services still need to be explored in greater depth. Thus, this study aimed to evaluate the determinants of timely access to Specialized Mental Health Services (outcome 1) and maintenance of a link with Primary Care after patients' admission (outcome 2). Methods This is a cross-sectional study, conducted with 341 users of Specialized Mental Health Services at outpatient and community level in a medium-sized city in Brazil between August and November 2019. Associations between the outcomes and the other variables were explored with the use of Poisson regression models with robust variance estimators. Results Factors positively associated with timely access were the diagnosis of psychosis or psychoactive substance misuse. The inversely associated factors with this outcome were higher income, having their need for mental health care identified in an appointment for general complaints, having been referred to the current service by Primary Care, having attended the current service for up to 3 years and delay until the first appointment (in a previous service). Regarding the maintenance of a link with Primary Care, factors positively associated were being referred to the current service by Primary Care or private service and receiving visits from Community Health Agents. The inversely associated factors with this outcome were male sex, being employed, having a diagnosis of psychosis or psychoactive substance misuse, and a greater perception of social support. Conclusions In addition to individual factors, factors related to the organization of services and the referral between them stood out in influencing both the access and maintenance of the patients' link with Primary Care. Thus, this study reinforces the idea that integration between Primary Care and Specialized Mental Health Services should be strengthened, both to reduce waiting times for between-service referrals and benefit of care continuity. (AU)

FAPESP's process: 18/10366-6 - Implementation research: network integration strategies in mental health in the city of Itatiba
Grantee:Rosana Teresa Onocko Campos
Support Opportunities: Research Grants - Research in Public Policies