title: Mental Health Policy in Brazil: federal expenditure evolution between 2001 and 2009.
abstract: OBJECTIVE
  To analyze the evolution of estimates of federal spending in Brazil's Mental Health Program since the promulgation of the national mental health law.
  
  
  METHODS
  The total federal outlay of the Mental Health Program and its components of hospital and extra-hospital expenses were estimated based on 21 expenses categories from 2001 to 2009. The expenses amount was updated to values in reais of 2009 by means of the use of the Índice de Preços ao Consumidor Amplo (Broad Consumer Price Index). The per capita/year value of the federal expenditure on mental health was calculated.
  
  
  RESULTS
  The outlay on mental health rose 51.3% in the period. The breakdown of the expenditures revealed a significant increase in the extra-hospital value (404.2%) and a decrease in the hospital one (-39.5%). The per capita expenditures had a lower, but still significant, growth (36.2%). The historical series of the disaggregated per capita expenditures showed that in 2006, for the first time, the extra-hospital expenditure was higher than the hospital one. The extra-hospital per capita value increased by 354.0%; the per capita hospital value decreased by 45.5%.
  
  
  CONCLUSIONS
  There was a significant increase in federal outlay on mental health between 2001 and 2009 and an expressive investment in extra-hospital actions. From 2006 onwards, resources allocation was shifted towards community services. The funding component played a crucial role as the inducer of the change of the mental health care model. The challenge for the coming years is maintaining and increasing the resources for mental health in a context of underfunding of the National Health System.
authors.affiliation: Programa de Pós-Graduação em Psiquiatria e Saúde Mental, Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil. renata.weber@gmail.com
authors.forename: Renata Weber
authors.initials: RW
authors.lastname: Gonçalves
authors.forename: Fabíola Sulpino
authors.initials: FS
authors.lastname: Vieira
authors.forename: Pedro Gabriel Godinho
authors.initials: PG
authors.lastname: Delgado
mesh_terms: D001938:Brazil; D002017:Budgets; D003156:Community Mental Health Services / Q000191:economics; D003362:Cost-Benefit Analysis / Q000191:economics; D005380:Financing, Government / Q000706:statistics & numerical data*; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006291:Health Policy / Q000191:economics*; D006801:Humans; D007256:Information Systems; D001523:Mental Disorders / Q000191:economics; D008605:Mental Health Services / Q000191:economics*; D009313:National Health Programs / Q000191:economics*; D040841:Resource Allocation / Q000191:economics