Although 289 (97.97%) of the 295 municipalities in Santa Catarina have a Municipal Health Plan, only 84 (28.47%) of them have programs aimed at caring for the population’s mental health. This is what an unprecedented survey carried out by the State Audit Court (TCE/SC) points out.
Coordinated by the Directorate of Special Activities (DAE), the study was based on a questionnaire composed of 194 questions on topics such as municipal strategies, suicide prevention, organizational structure, hospital care and hospitalization, financial resources, control and transparency, among others. The questionnaire was developed in conjunction with the State Department of Health (SES), the Municipal Health Department of Florianópolis (SMS Fpolis) and the Federal University of Santa Catarina (UFSC).
Applied in all 295 municipalities in Santa Catarina, the questionnaire made it possible to draw up a detailed diagnosis of services related to mental health in each location, providing a better understanding of the needs and challenges faced. The responses presented also showed that 160 municipalities (54.24%) carry out monitoring and evaluation of Mental Health actions, which shows, according to the report, the need to strengthen the monitoring of initiatives to ensure the effectiveness of these actions.
The procedure sought to identify strategies, guidelines and actions adopted by municipalities in Santa Catarina to organize assistance to people with specific mental health treatment and care needs.
The work, presented at this Monday’s session (29/1), by external control auditor Renato Costa, and under the supervision of advisor Luiz Eduardo Cherem, thematic rapporteur for Health at TCE/SC, also reveals that 183 (62.03%) municipalities in Santa Catarina carry out suicide prevention actions annually, which demonstrates the need to increase the frequency of these initiatives. Furthermore, the study reveals that only 57 municipalities (19.32%) have protocols for managing suicide risk.
Regarding specialized services and hospital admissions in mental health, the diagnosis revealed that only 14 municipalities (4.75%) have beds for this purpose in their own hospitals. The majority, 243 municipalities (82.37%), reported that they have difficulties in providing bed spaces for patients undergoing mental health or psychiatric treatment in general hospitals. “This scenario demands the urgent identification and addressing of barriers that prevent the adequate provision of these services”, highlights the technical area report.
Prevention as public policy
“Mental health is an essential component of the right to health, which is why the Public Administration has the responsibility to guarantee equitable access to these services, promoting the well-being of the population”, highlighted counselor Luiz Eduardo Cherem in the Plenary session this Monday (29/1).
Cherem recalled that based on this work, the Court of Auditors, through the thematic report related to health (of which he is the rapporteur), will develop a series of guidelines, suggestions and determinations for municipal and state managers, in order to contribute to the expansion and improvement of mental health care, with a focus on prevention, especially aimed at younger people. “By promoting, in a continuous and planned manner, awareness, with prevention as a true public policy, city halls contribute to changing attitudes towards mental health, encouraging the understanding that these issues are an integral part of general health and they deserve adequate attention and support”, he reinforced.
Among the deliberations of the TCE/SC to state public managers are:
* Promote intergovernmental partnerships, aiming to develop and strengthen mental health services in municipalities in Santa Catarina;
* Ensure an adequate organizational structure to carry out the state coordination of mental health services, through the composition of its functional staff with qualified professionals in sufficient numbers, in order to provide the necessary technical support to the municipalities of Santa Catarina;
* Continuously monitor and evaluate mental health services provided by municipalities, seeking greater effectiveness in care/care and assisting them when necessary;
* Provide necessary technical support to municipalities to implement effective strategies aimed at reducing waiting times for mental health care.
And to the heads of municipal Executive Powers, the TCE/SC advises, among other deliberations:
* Review and update Municipal Health Plans, incorporating proposals related to mental health, aligned with epidemiological data and territorial peculiarities;
* Raise awareness in the various areas related to mental health, with an emphasis on health, social assistance and education, to the importance of periodically discussing the topic within the scope of the Municipal Executive Branch;
* Prioritize support measures for family members and close friends of people at risk of suicide, cases of self-inflicted violence, suicide attempts and completed suicide;
* Improve and expand the active search for people with psychological distress or who may need mental health care in its territory.