The family health program and the rationale for matrix-based strategies in mental health, in the city of São Paulo, Brazil

Many global studies confirm that about 80% of mental disorders are chiefly low complexity, so that they could be treated at the level of primary care and not just by specialists (and Specialized Services).
In the City of São Paulo - Brazil, some Public Primary Healthcare Clinics are based on the strategy of the Family Health Program – PSF, which seeks to bring closer together healthcare and the community of a given region. Basic Health Units – UBSs are formed by teams with a General Practitioner, Nurse, Nursing Aides, and Community Health Agents.
Mental health care is provided under the logic of dehospitalization, with the implementation of Psychosocial Support Centers – CAPS’s. In accordance with this proposal, the Adult CAPS of Cidade Ademar was planned with the purpose of organizing local mental health care as proposed by the Brazilian Ministry of Health in its many levels of complexity through intensive and semi-intensive care. Their target audience are patients with severe and persistent mental disorders and their aim is the family and social inclusion of this population.
As to the other cases, under the responsibility of primary care, the CAPS’s have been structured with matrix-based strategies for outreach work with an extended team to provide support to UBS’s and care to other cases of mental illness, monitor studies and case discussions, hold joint appointments, active household outreach programs, and guidance on prevention and promotion activities.
This model has made it possible for PSF workers to see patients with mental disorders in a differentiated manner, following them up with confidence and skills in low complexity healthcare services.