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Table 1 SUS primary care and mental health services

From: Perceptions of health managers and professionals about mental health and primary care integration in Rio de Janeiro: a mixed methods study

Assistance model design Traditional model (Currently being deactivated) Primary care model (Currently being implemented)
Care focus Individual and disease-oriented Health, community and territory-oriented
Kind of Service General Traditional Outpatient Service (GTO) Mental Health Outpatient Service (MHOS) Family Health Strategy (FHS) Mental Health Matrix Support Teams (MHMS) Psychosocial Community Centre (PCC)
Care Level Primary Specialised Primary Primary Specialised for severe mental health patients
Coverage 100,000 inhabitants from a geographical area. This service is not commonly associated to patient’s territory. 3500 enrolled people in delimited territory. Each team covers up to 9 FHS teams, according to population size. 100,000 to 200,000 inhabitants from a defined geographical area, which depends on patient’s territory.
Access Design Consultations are booked on demand. Consultations are booked on referral from another health professional. Consultations and care are delivered in units located in the community. The evaluation focus considers not only the individual but also family and community context. Provides support to FHS teams and works in collaboration, assisting their patients. Consultations are booked either by referral or on demand.
Team Composition Internal medicine, paediatrics and gynaecology outpatient clinics provide general care. Frequently, there is also a mental health clinic. Psychiatrists and psychologists. Multidisciplinary team comprise: 1 family physician, 1 nurse, 1 nursing technician and 6 community health workers. Perform active search of patients. Work according to primary care premises: gateway, longitudinally, comprehensiveness and care coordination. Multidisciplinary team composed of professionals, including one mental health professional (e.g. a psychologist or a psychiatrist). Health managers define the team based on epidemiological data, local needs and the number of health teams to be supported. Multidisciplinary team consisting of: neurologists, nurses, nursing technicians, pharmacists, nutritionists and psychiatrists, psychologists, social workers, speech therapists, music therapists, occupational therapists, among other multi non-specialised professionals admitted to the team.
Mental Health Clinical and Assistance offers Referred patients with mental health problems to a mental health outpatient clinic. Specialty consultations based on referral and counter-referral proceedings.
Their routine does not include working with primary care professionals.
When patients with mental health problems are identified, FHS requests the support of MHMS Teams and works in collaboration with them to provide mental health care in the community. MHMS works at least once a month with FHS teams in order to improve the FHS teams capacity to identify emotional suffering and take care of it and monitor mental health cases. This includes integrating care actions delivering mental health care in the territory. Provide care to patients with severe mental problems. PCC works with FHS under two circumstances: either referring their own patients to FHS teams or helping FHS teams provide care to severe mental health patients already being treated by the FHS teams.