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Social Psychiatry and Psychiatric Epidemiology
Published in: Social Psychiatry and Psychiatric Epidemiology 5/2011

01-05-2011 | Original Paper

Shortage and underutilization of psychiatric beds in southern Brazil: independent data of Brazilian mental health reform

Authors: Rafael Henriques Candiago, Sergio da Silva Saraiva, Veralice Gonçalves, Paulo Belmonte-de-Abreu

Published in: Social Psychiatry and Psychiatric Epidemiology | Issue 5/2011

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Abstract

Background

Mental health policies throughout the world are being subjected to several changes due to increased pressure from the public and from health administrators. Mental health policies in the developing world experienced changes following advice and consultation from the World Health Organization (WHO). This was the case with Brazil, which enacted several laws and policies affecting community care and the closure of beds in psychiatric hospitals (the deinstitutionalization movement). Rio Grande do Sul, the southeast state in Brazil, adopted this policy in 1992, but still suffers from a shortage of psychiatric beds in both general hospitals (GHs) and psychiatric hospitals (PHs), despite advances in the provision of community care. As a result, Rio Grande do Sul (RS) can be studied as an example of “what actually happens” in mental health care in the developing world.

Methods

The study analyzed online administrative data from 2000 to 2007 for three main parameters of mental health care (i.e. hospital use rate, length of stay, and hospital bed capacity). These were used to evaluate differences in psychiatric care among GHs and PHs. The number of existing and required psychiatric beds in RS was also calculated.

Results

GHs had very low hospital use rates, while PHs had a very high length of stay (200% higher than GH). The number of admissions to GHs grew by 170% over the 8 year period, and psychiatric bed availability was 1.5 per 10,000 inhabitants.

Conclusions

The study provided evidence for the need of 30–50% more psychiatric beds in GHs. Also, additional staff training is needed to increase use rates in GHs and decrease the length of stay in PHs. Additional studies covering national data must be carried out to assess the extent of these problem in other Brazilian mental health care services.
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Metadata
Title
Shortage and underutilization of psychiatric beds in southern Brazil: independent data of Brazilian mental health reform
Authors
Rafael Henriques Candiago
Sergio da Silva Saraiva
Veralice Gonçalves
Paulo Belmonte-de-Abreu
Publication date
01-05-2011
Publisher
Springer-Verlag
Published in
Social Psychiatry and Psychiatric Epidemiology / Issue 5/2011
Print ISSN: 0933-7954
Electronic ISSN: 1433-9285
DOI
https://doi.org/10.1007/s00127-010-0207-1

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