Enhancing the capacity of the Brazilian health system to support the mental health of young people

点击翻译按钮获取中文摘要

Mental health problems affect a significant proportion of young people in Brazil, and can have long-lasting negative consequences, leading to poor school achievement, troubled family relationships, difficulties in keeping stable jobs and involvement with crime and drugs. Mental health problems affect more young people in low- and middle-income countries (LAMICs), than in the high-income ones. LAMICs such as Brazil; however, have fewer resources to provide young people with the effective mental health care they need. Additionally, health professionals working in primary care settings, where most people with mental health problems could be treated, often don't have access to proper training and/or technical resources to deliver treatment to young people with mental health problems. We are developing a research project which aims to enhance the capacity of the Brazilian health system to support the mental health of young people. Our project comprises three activities: in the first activity, we will estimate the number of young people in Brazil who need mental health care through analysis of existing data collected from all five regions in Brazil. We will, then, estimate the economic impact of child and adolescent mental health problems, and how much the country would save by delivering effective treatment for young people with mental health problems, considering that improved mental health should lead to improvement in education achievement and employment prospects, and reduction in the use of drugs and contact with criminal justice.In the second activity, we will generate evidence on effective and affordable interventions that can be implemented in the Brazilian health system to support young people with mental health problems through a systematic review of existing scientific literature. We will focus our review on interventions for prevention and treatment which have been proven cost-effective in Brazil or similar countries and that are, therefore, suitable for the Brazilian context.In the third activity, we will use evidence generated through activities one and two to develop a practical toolkit and training material to support health professionals and policymakers to adapt and implement mental health treatment that is suited to the local reality. It will help them estimate how much it will cost to provide these services and what the long term costs and benefits will be.To ensure that our results will be translated into public health policymaking, and the applicability of our toolkit in different regional contexts, we have assembled a multi-professional team of researchers from the London School of Economics and Political Sciences (LSE), in the UK, and from three Brazilian universities - the State University of Mato Grosso do Sul (UEMS) in the Central-West region, Federal University of Alagoas (UFAL), in the Northeast, and Federal University of Minas Gerais (UFMG), in the Southeast. These three regions (Northeast, Central-West and Southeast) comprise 48% of Brazil's territory and 77% of the country's population. Our research team will work with a Stakeholder Impact Advisory Group (SIAG), which will comprise policymakers from Brazil's five regions and administrative levels (municipality, state and federal), public health practitioners, and representatives from service-user organizations. The SIAG's feedback and advice will be fundamental to the tailoring of our toolkit and training package according to different reginal reality and needs.One important outcome of our project will be the capacity building of researchers in each university. This will facilitate future research and links between researchers and stakeholder groups after the three-year timeframe of the project we are submitting to the UK Medical Research Council and Brazil's Council of State Research Foundations.