Evidence map›Paper›PMID 30450125›Full record

ReviewInternational journal of mental health systems2018

Systematic review of pathways to mental health care in Brazil: narrative synthesis of quantitative and qualitative studies.

Carlos Eduardo Amaral, Rosana Onocko-Campos, Pedro Renan Santos de Oliveira, Mariana Barbosa Pereira, Éllen Cristina Ricci, Mayrá Lobato Pequeno, Bruno Emerich, Roseléia Carneiro Dos Santos, Graham Thornicroft

Open access · goldAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in International journal of mental health systems, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
28citing papers in PubMed, 2 pooled it
5.4field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

28 citing papers in PubMed, 2 syntheses or guidelines pooled it, 56 citations in OpenAlex.

  1. Brazilian Psychiatric Association guidelines for the treatment of social anxiety disorder.Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999) · 2025
    Guideline
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 5 institutions in 2 countries.

Carlos Eduardo Amaral1Department of Collective Health, School of Medical Sciences, University of Campinas, Campinas, Brazil.ORCID 0000-0002-1719-1080
Rosana Onocko-Campos1Department of Collective Health, School of Medical Sciences, University of Campinas, Campinas, Brazil.
Pedro Renan Santos de OliveiraUnichristus, Fortaleza, Brazil.
Mariana Barbosa Pereira1Department of Collective Health, School of Medical Sciences, University of Campinas, Campinas, Brazil.
Éllen Cristina Ricci1Department of Collective Health, School of Medical Sciences, University of Campinas, Campinas, Brazil.
Mayrá Lobato Pequeno4Department of Community Health, Federal University of Ceará, Fortaleza, Brazil.
Bruno Emerich1Department of Collective Health, School of Medical Sciences, University of Campinas, Campinas, Brazil.
Roseléia Carneiro Dos Santos4Department of Community Health, Federal University of Ceará, Fortaleza, Brazil.
Graham Thornicroft5Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Universidade Estadual de Campinas (UNICAMP) · BRUniversidade Federal do Ceará · BRKing's College London · GBUnichristus · BRUniversidade Estadual do Ceará · BR

Funding

COBALT: Comorbid Affective Disorders, AIDS/HIV, and Long Term HealthR01MH100470 · NIMH · KING'S COLLEGE LONDON · PI FAIRALL, LARA ROSEMARY, PETERSEN, INGE · 2013 to 2018
$2.0M
Medical Research Council MR/R023697/1Medical Research Council MR/S001255/1NIMH NIH HHS R01 MH100470
6 · The paper itself

Abstract

backgroundPathways to care are actions and strategies employed by individuals in order to get help for health-related distress and the related processes of care providers. On several systematic reviews regarding pathways to mental health care (PMHC), studies regarding South American countries were not present. This review synthesizes qualitative and quantitative research about PMHC in Brazil.

methodsLILACS, MEDLINE and SCIELO databases were searched for papers regarding PMHC in Brazil. The results were organized in pathway stages, based on Goldberg and Huxley's 'model of Levels and Filters' and on Kleinman's framework of 'Popular, Folk and Professional health sectors'. Analysis also considered the changes in national mental health policy over time.

results25 papers were found, with data ranging from 1989 to 2013. Complex social networks were involved in the initial recognition of MH issues. The preferred points of first contact also varied with the nature and severity of problems. A high proportion of patients is treated in specialized services, including mild cases. There is limited capacity of primary care professionals to identify and treat MH problems, with some improvement from collaborative care in the more recent years. The model for crisis management and acute care remains unclear: scarce evidence was found over the different arrangements used, mostly stressing lack of integration between emergency, hospital and community services and fragile continuity of care.

conclusionsThe performance of primary care and the regulation of acute demands, especially crisis management, are the most critical aspects on PMHC. Although primary care performance seems to be improving, the balanced provision and integration between services for adequate acute and long-term care is yet to be achieved.

Indexed as

Clinical pathwaysMental health policyPathways to carePublic healthSystematic review

Identifiers

PMID30450125
PMCPMC6208112
OpenAlexW2898979387

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.