Opinion – Public Health: Mental health proposals respond to public health challenges

In early July, the “More SUS Agenda: Evidences and Paths to Strengthen Public Health in Brazil” was launched. The Agenda is a realization of the Institute of Studies for Health Policies (IEPS) and Umane, and aims to contribute to the public electoral debate based on diagnoses and concrete proposals for the improvement of the Unified Health System (SUS). In total, six paths are presented, one of which is aimed at mental health, built in partnership with the Cactus Institute, based on four major proposals to be prioritized by the next government officials with a view to valuing and promoting Mental Health.

“Paths to Strengthen Public Health in Brazil”: download the full proposal document here.

Construction Assumptions

The inclusion of mental health as one of the structuring axes of this programmatic content for the Executive Branch started from some guiding premises:

1. There is difficulty in accessing mental health services in the country and care is significantly unequal among the population. In the case of depression, for example, the prevalence is higher among women and people with lower incomes, while access to treatment is lower in the black population when compared to white people;

2. There is a gap in the assessment of the impact of public policies on mental healthcorroborated by a difficulty in accessing updated and published data from the Executive Branch;

3. It is necessary to understand mental health as a multicausal phenomenon and, therefore, we need an interdisciplinary look at the topic;

4. Looking at children and adolescents is essential for prevention. This is an audience particularly impacted by the pandemic and neglected in current public policies and;

5. The prioritization of mental health among health policies is necessary. In fact, such prioritization is recommended by the United Nations (UN) to minimize the consequences of the pandemic on the population and is one of the Sustainable Development Goals (SDGs) in the 2030 Agenda to ensure healthy lives and promote well-being for all people. people.

To arrive at the proposals highlighted below, Instituto Cactus and IEPS joined a group of experts with experience in the three levels of government, who worked together to produce consensus in the area. Roberto Tykanori (former National Coordinator of Mental Health), Daniel Elia (Coordinator of Psychosocial Care of the State of Rio de Janeiro), Chenya Coutinho (former Mental Health Coordinator of Aracaju/SE) and Giovanni Salum (former Health Coordinator Mental de Porto Alegre/RS) were part of this group.

Through public policies that promote respect for differences and guarantee human rights, we are approaching a society that is less stigmatizing and prejudiced. To achieve this objective, we highlight, among other proposals, the need to significantly increase the public budget for mental health; technical and financial support to promote deinstitutionalization; the viability of the National Conference on Mental Health; the implementation of a Management Council in mental health services, with user representation; the generation of employment and income for people with mental disorders; the induction of the formulation of a National Housing Policy that prioritizes the most vulnerable; and the prioritization of the public of children and adolescents, through specific policies and the participation of this public in the debate and formulation of public policies.

The Mental Health proposals, as well as the entire Mais SUS Agenda, also received support from the National Council of Health Secretaries (CONASS), Center for Studies and Research on Health Law (CEPEDISA), Instituto Veredas, Vital Strategies, República.org, Impulse Gov and the Political Action Network for Sustainability (RAPS). This is just the beginning of the creation of a network in defense of the strengthening of the SUS, which is distinguished by having an impact before, during and after the elections. These are concrete proposals that were elaborated from the need to respond to the current challenges of the system and from analyzes of technical feasibility and policy for future implementation.

We cannot improve the health of Brazilians without looking at mental health. Based on collectively formulated proposals, we intend to impact new public managers, parliamentarians and decision-makers, who will be able, in their mandates, to guarantee rights and care for everyone, without restrictions.

>> For agenda suggestions, partnerships and comments, please contact us at [email protected] and [email protected]. Until the next Mental Health on the Agenda!