Opinion – Saúde em Público: Government that produces quality information can reduce the mental suffering of the population

To choose the clothes you will wear to go out today, you need to consider the weather and the destination. To choose the path you will take there, you need to consider the time available and the route that best meets your needs. To choose who your candidates are, you need to know the proposals of each one and to go to vote, you will also need to choose the best clothes and the best way… With public policies it is no different, for the manager to decide how he will do it. to implement them, monitor them and, later, evaluate them, he needs information – and not only managers, but also the people who are affected by these policies and the researchers who are fundamental for the improvement of actions. In mental health policies, so important in this troubled moment in which we live, the same happens and access to transparent and quality information about the main disorders, on how to treat and prevent them is a problem.

Mental health policies directly depend on the existence and availability of primary, accurate and up-to-date data and information, and this should be a timeless guideline. Through this, it is possible to have visibility of the impacts achieved, recognize and encourage actions that promote health, including the defense of human rights. Only by generating information and encouraging constant monitoring and inspection will it be possible to guide the planning of public policies through robust evidence, improving decision-making and the allocation of resources in the area. Therefore, this is one of the proposals of the Mais SUS Agenda for Mental Health, which unfolds in three steps.

The first one consists of the articulation of the Ministry of Health with the Ministry of Science and Education to promote the production of research in Mental Health, through the financing of lines of research on the subject. According to the Pathways in Mental Health survey, from 2002 to 2020, the Department of Science and Technology of the Department of Science, Technology and Strategic Inputs of the Ministry of Health (Decit/SCTIE/MS) financed 6,461 health research projects , which totaled an investment of R$ 1.4 billion. For the specific field of mental health, in the same period, only 249 projects were financed, totaling R$ 27 million.

The second step is to encourage the implementation of a culture of monitoring and evaluation of public policies on Mental Health, to be carried out by the Health Surveillance Secretariat (SVS/MS), linked to the generation of research, knowledge and data, including bringing information referring to institutionalized or homeless people. Today, when noticing that the Executive Branch finds it difficult to say how many these people are, where they are or what their main needs are, it is difficult to envision a prioritization of the quality of life of the most vulnerable. It is urgent in the current context of generalized worsening of the living conditions of Brazilians that these actions are prioritized and are in accordance with the Open Data Policy and integrated with the Digital Health Strategy to accompany the necessary advance of the computerization of the Public Power.

Learn more about these and other proposals for Mental Health in the Mais SUS Agenda

The third step, and no less important, is the guarantee of policies aimed at prevention. Children and adolescents should be the target audience in the systematization of monitoring and prioritized in the integration with epidemiological surveillance, which, ideally, should be integrated with other sectors, such as schools. The recent experience of the Covid-19 pandemic has further accentuated the urgency of actions focused on children’s mental health. According to data from the Youth Atlas, in 2020, 70% of young people reported worsening emotional state with the pandemic. A population that requires special attention are LGBTQIA+ youth and those in unfavorable economic situations, who are known to have worse mental health indicators.

For this, among the existing systems, the Ministry of Health must implement electronic medical records compatible with the SIA-SUS which, in addition to production indicators, must include indicators of adherence, supervision, matrix support and hospitalization time through appropriate tools, which should also be included in the Municipalities’ Management Reports (RAG). The Executive Branch should also be responsible for preparing professionals to use these electronic systems, through training and qualification courses to be carried out in partnership with states and municipalities and offering material resources for the implementation of these electronic medical records.

Governments that do not produce good information about their policies and about the users of these services contribute to the increase in mental suffering, since its reduction can only be achieved through quality, transparent and up-to-date scientific evidence. To the extent that access to data is difficult and that they are not collected with sufficient quality, quantity and frequency, those who most need attention from the Government and access to proper care no longer receive it. Brazil needs a serious policy for the production and use of quality data. Among the good examples of the use of available data, the mental health project in data stands out, developed by the Cactus Institute, in partnership with Impulso Gov, which integrates data from multiple government databases to provide useful information for public management. Just as you informed yourself before choosing your clothes and defining the best way to reach your destination, it is up to the Executive Branch to choose to prevent and promote the mental health of Brazilians and, for that, it is essential to inform and monitor the health in a broader, more consistent and publicized way.