Table 2 Degree of implementation (DI) of components, subcomponents, and evaluative criteria of the process dimension of community mental health care network (RAPS), Minas Gerais, Brazil, 2020
From: Community mental health care network: an evaluative approach in a Brazilian state
Component | Subcomponent | Activity | Evaluative criterion | Maximum points | Degree of implementation (DI) % |
|---|---|---|---|---|---|
Minimum units DI 62.9% | Mental Health Care DI 66.7% | Multidisciplinary and shared care DI 68.2% | Multidisciplinary care with shared decisions in municipal mental health care | 10 | 74.1 |
Participation of the psychiatrist (municipal or from other agreed municipalities) in the discussion of the case | 06 | 50.9 | |||
Comprehensive case care of users with common mental disorders by primary healthcare services | 10 | 77.2 | |||
Comprehensive case care of users with severe mental disorders by primary healthcare services | 10 | 69.5 | |||
Comprehensive case care of users in psychological distress secondary to the use of alcohol or other drugs by primary healthcare services | 10 | 64.2 | |||
Assistance to children and adolescents with psychological distress in municipal services | 10 | 66.3 | |||
Therapeutic workshops and/or expressive or physical group activities DI 61.7% | Presence of therapeutic workshops and/or expressive or physical group activities in municipal mental health care | 10 | 61.7 | ||
Elaboration of the singular therapeutic project DI 61.7% | Elaboration of the singular therapeutic project | 08 | 61.7 | ||
Crisis management DI 65.3% | Crisis care in municipal or neighboring agreed-on Psychosocial Care Centers in the region | 10 | 70.4 | ||
Crisis management without referral to the psychiatric hospital | 10 | 56.5 | |||
Assistance to severe cases of psychic suffering secondary to the use of alcohol or other drugs in municipal or neighboring agreed-on Psychosocial Care Centers in the region | 10 | 68.9 | |||
Conversation circles and/or other approaches to health promotion, self-care, appropriate use of medications, and/or prevention of alcohol or other drug abuse DI 70.5% | Offer of conversation circles, groups, workshops, or other actions on health promotion | 06 | 82.4 | ||
Strategies for preventing the harmful use of alcohol or other drugs | 08 | 61.5 | |||
Psychosocial rehabilitation DI 48.6% | Promotion of leisure alternatives such as sports and cultural activities DI 65.2% | Promotion of sports and/or cultural activities for the population by the municipality | 06 | 65.2 | |
Deinstitutionalization DI 36.1% | Actions for deinstitutionalization of long-term users in psychiatric hospitals or other institutions | 08 | 36.1 | ||
Psychosocial interventions DI 55.1% | Psychosocial interventions for user integration into community support networks | 10 | 55.1 | ||
Actions to increase the autonomy of users DI 52.3% | Actions to increase the autonomy of users | 10 | 57.3 | ||
Inclusion of users in the labor market DI 31.3% | Actions to insert the user into the labor market | 08 | 31.3 | ||
Connectivity DI 61.7% | Network articulation DI 61.7% | Team meetings, network meetings, matrix support of primary care teams, of the urgency and emergency networks, and reference hospital services DI 61.5% | Case discussions among the team members | 10 | 74.4 |
Case discussions between teams of different services | 10 | 62.7 | |||
Connection of actions between the different services | 10 | 57.2 | |||
Collaborative care actions in mental health at municipal mental health care network | 10 | 74.8 | |||
Inclusion of case discussions or joint casework in collaborative care actions | 10 | 59.8 | |||
Weekly attendance of collaborative care professionals at the units | 06 | 37.8 | |||
Case discussions between the team accompanying the user and the hospital team when users are hospitalized (for reasons related to mental health) | 08 | 51.3 | |||
Network meetings (involving professionals from various services of the municipal mental health care network) | 10 | 41.0 | |||
Development of actions in conjunction with other sectors of the Public Administration for case management or health promotion (e.g., justice, leisure, education, sports, social work) DI 60.8% | Development of actions in conjunction with other sectors of the municipal administration | 10 | 60.8 | ||
Integration DI 61.7% | Governance DI 60.0% | Creation of specific spaces for mental health management at the municipal, regional, state, and federal levels DI 46.2% | Presence of a specific coordinator for mental health at the municipal level | 08 | 46.2 |
Establishment of Regional RAPS DI 64.0% | Agreements between regional municipalities for the sharing of mental health care network services | 10 | 78.2 | ||
If yes to the previous question: are the pacts in which the municipality participates adequate for the mental health care users? | 08 | 45.5 | |||
Care Management DI 62.2% | Construction of flows between the various RAPS services DI 55.4% | Existence of structured flows for the circulation of users through the various health services of the local mental health care network | 08 | 55.4 | |
Responsibility of one or more professionals by the user along their path with RAPS DI 64.3% | Assignment of one or more professionals to be responsible for each user during their course through the mental health care network | 08 | 68.5 | ||
Existence of discussion among professionals to articulate a joint care project in the transition between services | 06 | 57.3 | |||
Co-responsibility for the user among the professionals of different services of RAPS DI 58.6% | Existence of co-responsibility of professionals from different services in the follow-up of the case | 06 | 58.6 | ||
Normativity DI 54.8% | Mental Health Policy DI 63.5% | Knowledge and acceptance of government guidelines, protocols, and instructions for mental healthcare by the correspondent professionals DI 77.6% | Basis of mental health actions in the municipality in the guidelines of the National Mental Health Policy | 10 | 81.8 |
Knowledge by the municipality's mental health professionals about how the mental health care network operates | 06 | 68.9 | |||
Evaluation and monitoring DI 35.7% | Actions for evaluation and monitoring of mental health care at the municipal leve | 08 | 35.7 | ||
Participation and social control DI 47.0% | Assembly of users DI 20.8% | Existence of user assemblies in municipal mental health services | 08 | 20.8 | |
Approaches that put the expressed needs of users at the heart of their care DI 65.4% | Participation of users and/or their families in decisions about their therapeutic projects | 08 | 65.4 | ||
Participation of professionals, users, and family members in collegiate, commissions, forums, or other spaces for collective discussions on mental health DI 46.4% | Participation of users and family members in spaces of collective discussion in mental health | 06 | 35.6 | ||
Participation of municipal mental health care network professionals in spaces of collective discussion about mental health | 06 | 53.3 |