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

Autor(es)

dos Santos Treichel, Carlos Alberto ^[1] ; Bakolis, Ioannis ^[2] ; Onocko-Campos, Rosana Teresa ^[1]

Afiliação do(s) autor(es)

^[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

• Tipo de documento: Artigo Científico
• Fonte: INTERNATIONAL JOURNAL OF MENTAL HEALTH SYSTEMS; v. 15, n. 1 DEC 4 2021.
• Citações Web of Science: 0

Resumo

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)

• Processo FAPESP: 18/10366-6 - Pesquisa de implementação: dispositivos de integração da rede de saúde mental no município de Itatiba-SP
• Beneficiário: Rosana Teresa Onocko Campos
• Modalidade de apoio: Auxílio à Pesquisa - Pesquisa em Políticas Públicas