title: Factors Associated with Providers' Perceptions of Mental Health Care in Santa Luzia's Family Health Strategy, Brazil.
abstract: Brazil has a unique mental health care system, characterized by universal coverage delivered by interdisciplinary teams both in the community and in specialized centros de atenção psicossocial (CAPS-psychosocial care centers). Provision of patient-centered mental health care is an important principle of Brazilian mental health care, but this topic has not been well-studied. We analyzed data from a cross-sectional survey of 151 community health workers (CHWs), nurses, and physicians in Santa Luzia, Minas Gerais State, Brazil. Chi-squares, t-tests and multivariate regression analyses examined differences in socio-demographics, caseload, engagement in evidence-based practices (EBPs), and transdisciplinary collaboration between providers who reported providing high levels of patient-centered mental health care and those who did not. In multivariate regression models, components of transdisciplinary collaboration were significantly associated with providers' perceptions of patient-centered mental health care (p < 0.05). CHWs were also significantly more likely to report providing patient-centered care than physicians and nurses. EBP engagement and sociodemographics were not associated with perceptions. Results suggest that training efforts to improve patient-centered mental health care in Brazil could build upon CHWs' skills and focus on transdisciplinary collaboration. Findings may inform practice in other countries with similar health care systems.
authors.affiliation: Brookdale Center for Healthy Aging, Hunter College of the City University of New York, 2180 Third Ave, New York, NY 10035, USA. ag1428@hunter.cuny.edu.
authors.forename: Angela R
authors.initials: AR
authors.lastname: Ghesquiere
authors.affiliation: School of Social Work, University of Michigan, Room 3792 SSWB, 1080 S. University Ave., Ann Arbor, MI 48109, USA. ropinto@umich.edu.
authors.forename: Rogerio M
authors.initials: RM
authors.lastname: Pinto
authors.affiliation: School of Social Work, Columbia University, 1255 Amsterdam Avenue, New York, NY 10027, USA. rr2640@columbia.edu.
authors.forename: Rahbel
authors.initials: R
authors.lastname: Rahman
authors.affiliation: New York City Department of Health and Mental Hygiene, 42-09 28th St, Long Island City, NY 11101, USA. aspector@health.nyc.gov.
authors.forename: Anya Y
authors.initials: AY
authors.lastname: Spector
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D001938:Brazil; D003150:Community Health Workers; D003430:Cross-Sectional Studies; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D033183:Interdisciplinary Communication; D008297:Male; D008605:Mental Health Services; D008875:Middle Aged; D009726:Nurses; D018802:Patient-Centered Care; D010820:Physicians; D011787:Quality of Health Care
keywords: community health workers; mental health care; transdisciplinary collaboration