Expenses of mental health policy and the direction of psychiatric reform.
Name: EDINEIA FIGUEIRA DOS ANJOS OLIVEIRA
Publication date: 26/06/2017
Advisor:
Name |
Role |
|---|---|
| MARIA LUCIA TEIXEIRA GARCIA | Advisor * |
Examining board:
| Name |
Role |
|---|---|
| JEANE ANDRÉIA FERRAZ SILVA | Internal Examiner * |
| MARIA LUCIA TEIXEIRA GARCIA | Advisor * |
Summary: The object of this thesis is to investigate the mental health federal financing between 2001 and 2016, identifying how can the direction of the lines of expenditures are configures as a strategy sometimes to expand and sometimes to restraint the premises of the Brazilian Psychiatric Reform. In order to achieve goals, we conducted a mixed approach research, involving documentary research based on the national health management plans and reports, elaborated between 2000 and 2015, and the data obtained in the databases of Informatics Department of the Health Unique System, System of Information about
Public Budgets in Health and data sent by the Health Ministry by the Electronic
System of the Citizen Information Service between 2000 and 2016. Regarding the expenditures made by the Federal Government with the stock and services of mental health in the period of 2001 to 2016, we carved out a historical series directing the resources by actions and services. During the last 15 years, the Ministry of Health has spent an average of 2.4% (median of 2.35%) of SUSs annual budget on mental
health. Until 2006, the majority of the resources were destined to hospital stocks and from 2006 in all years, extra hospital expenses were higher than hospital expenses. Since 2006 the expenditures on stocks an extra hospital services, continued to grow until 2010. Between 2011 and 2014, the tendency was decreasing with an increase in 2015, the year of greater expending on extra hospital stocks. In the meantime, in 2016, the expenses went back to its tendency representing the lowest expenses on extra hopital stocks since 2008. We observed that the decrease on extra hospital expenses from 2010 was related to the reduction of total mental health expenditures. We have identified that the investment in social reintegration stocks, essential to the consolidation of the law as well as investments in the creation of assistance mechanisms that promote the process of social reintegration, have been gradually reduced over the years. In all of this years, the expenses on medicine consumed more than one third of the amount
spent with extra hospital stocks and, in a couple of years, was above expenses with the Center for Psychosocial Care. We conclude that the direction of spending does not point to consolidation of the Psychiatric Reform, since it reaffirms, with the directing of the expenditures for the
extra hospital stock, and not denies its principles and the principles of the Law 10.216/2001, in view of the insufficient destination of resources in the implementation of mental health policy and in actions to consolidate substitutive services and the presence of private interests that make it difficult to establish an extra hospital network with care devices that guarantee coverage of assistance to mental health users, as assured by the Federal Constitution of 1988.
