{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,14]],"date-time":"2026-11-14T06:53:01Z","timestamp":1794639181313,"version":"4.9.1"},"reference-count":27,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,2,26]],"date-time":"2025-02-26T00:00:00Z","timestamp":1740528000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,2,26]],"date-time":"2025-02-26T00:00:00Z","timestamp":1740528000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Prim. Care"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The \u201cMental Health Care in Primary Health Care (PHC)\u201d project (SMAPS, from Portuguese) was developed in six health regions from three Brazilian states. Considering the gap and relevance of monitoring and assessing mental health (MH) care in real-world settings using data from service records, this study aimed to evaluate the effect of SMAPS on indicators of MH care process in PHC, calculated from official records available in health services.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is a pilot study conducted between January 2022 and September 2023. The sample comprised 18 PHC units in 14 municipalities, which were in one of the three Brazilian states that adhered to SMAPS and assigned to one of two groups: control and intervention (2:1). Secondary data were collected at two times using the same instrument to systematize the retrieval of aggregated data, which were extracted from management reports from PHC units or municipalities departments. Data analysis was performed using descriptive statistics at the PHC units or municipality level.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The rate of referrals to MH specialties per consultation with a MH classifications record seemed to decline in intervention and control group. The percentage of benzodiazepine medications delivered for PHC decreased from 16.1 to 11.3% in the intervention group municipalities but increased from 20.3 to 24.1% in the control group. An inverse pattern was observed for antipsychotic, anticonvulsant, and antidepressant medications (increased from 82.2 to 86.2% in the intervention group municipalities and declined from 77.6 to 74.4% in the control group). Despite this, analyzing the mean variation in MH care indicators, statistically significant differences between groups in distribution at the 5% level were not identified.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The present pilot study points to possible effects of SMAPS for organizing MH care in PHC, especially regarding the referrals to specialty mental health care and the delivery of psychotropic medications. It contributes to the formulation of proposals for evaluating MH care based on data already available from records and reports from health services and emphasizes the need to improve the quality of MH care recording in PHC work routines.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12875-025-02735-y","type":"journal-article","created":{"date-parts":[[2025,2,26]],"date-time":"2025-02-26T07:57:09Z","timestamp":1740556629000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The effect of an intervention for organizing primary mental health care in Brazil: a study based on routine process indicators"],"prefix":"10.1186","volume":"26","author":[{"given":"Ilana","family":"Eshriqui","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Let\u00edcia Yamawaka","family":"de Almeida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joana Moscoso Teixeira","family":"de Mendon\u00e7a","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leandro","family":"Anazawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorrayne","family":"Belotti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Fortes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Alice Freire","family":"Sousa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evelyn Lima","family":"de Souza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudielle","family":"de Santana Teodoro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daiana","family":"Bonfim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joel","family":"de Almeida Siqueira Junior","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio Cleilson Nobre","family":"Bandeira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas Reis","family":"Correia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,2,26]]},"reference":[{"key":"2735_CR1","doi-asserted-by":"crossref","unstructured":"Collaborators GBD. 2019 MD. Global, regional, and national burden of 12 mental disorders in 204 countries and territories, 1990\u20132019: a systematic analysis for the Global Burden of Disease Study 2019. The Lancet Psychiatry. 2022;9(2):137\u201350.","DOI":"10.1016\/S2215-0366(21)00395-3"},{"issue":"2","key":"2735_CR2","doi-asserted-by":"publisher","first-page":"e89","DOI":"10.1016\/S2468-2667(18)30203-2","volume":"4","author":"DV Vigo","year":"2019","unstructured":"Vigo DV, Kestel D, Pendakur K, Thornicroft G, Atun R. Disease burden and government spending on mental, neurological, and sBHUtance use disorders, and self-harm: cross-sectional, ecological study of health system response in the Americas. Lancet Public Heal. 2019;4(2):e89\u201396.","journal-title":"Lancet Public Heal"},{"key":"2735_CR3","doi-asserted-by":"crossref","unstructured":"Keynejad R, Spagnolo J, Thornicroft G. WHO mental health gap action programme (mhGAP) intervention guide: updated systematic review on evidence and impact. Evid Based Ment Heal. 2021;24(3):124 LP \u2013 130.","DOI":"10.1136\/ebmental-2021-300254"},{"issue":"9803","key":"2735_CR4","doi-asserted-by":"publisher","first-page":"1654","DOI":"10.1016\/S0140-6736(11)61093-3","volume":"378","author":"R Kakuma","year":"2011","unstructured":"Kakuma R, Minas H, Van Ginneken N, Dal Poz MR, Desiraju K, Morris JE, et al. Human resources for mental health care: current situation and strategies for action. Lancet. 2011;378(9803):1654\u201363.","journal-title":"Lancet"},{"key":"2735_CR5","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12913-016-1768-9","volume":"16","author":"B Acharya","year":"2016","unstructured":"Acharya B, Tenpa J, Thapa P, Gauchan B, Citrin D, Ekstrand M. Recommendations from primary care providers for integrating mental health in a primary care system in rural Nepal. BMC Health Serv Res. 2016;16:1\u20138.","journal-title":"BMC Health Serv Res"},{"issue":"11","key":"2735_CR6","doi-asserted-by":"publisher","first-page":"e0206440","DOI":"10.1371\/journal.pone.0206440","volume":"13","author":"AOR Vistorte","year":"2018","unstructured":"Vistorte AOR, Ribeiro W, Ziebold C, Asevedo E, Evans-Lacko S, Keeley JW, et al. Clinical decisions and stigmatizing attitudes towards mental health problems in primary care physicians from latin American countries. PLoS ONE. 2018;13(11):e0206440.","journal-title":"PLoS ONE"},{"key":"2735_CR7","doi-asserted-by":"crossref","unstructured":"Cardoso LCB, de Arruda GO, Giacon-Arruda BCC, Paiano M, de Pinho LB, Marcon SS. Work process and mental health care flow in primary health care. Texto Context. 2020;29.","DOI":"10.1590\/1980-265x-tce-2019-0191"},{"key":"2735_CR8","doi-asserted-by":"publisher","first-page":"e00267720","DOI":"10.1590\/0102-311x00267720","volume":"37","author":"PR Sanine","year":"2021","unstructured":"Sanine PR, Silva LIF. Sa\u00fade mental e a qualidade organizacional dos servi\u00e7os de aten\u00e7\u00e3o prim\u00e1ria no Brasil. Cad Saude Publica. 2021;37:e00267720.","journal-title":"Cad Saude Publica"},{"key":"2735_CR9","unstructured":"World HO. 2008. mhGAP: mental health gap action programme: scaling up care for mental, neurological and substance use disorders. Geneva:. Available from: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK310851\/"},{"issue":"Supl 3","key":"2735_CR10","first-page":"1","volume":"57","author":"JMT de Mendon\u00e7a","year":"2023","unstructured":"de Mendon\u00e7a JMT, Eshriqui I, de Almeida LY, Gomes Filho VV, Schunk L, de Sousa AAF, et al. Conhecimento De Profissionais Da aten\u00e7\u00e3o prim\u00e1ria em sa\u00fade mental: diagn\u00f3stico pelo mhGAP. Rev Saude Publica. 2023;57(Supl 3):1\u201313.","journal-title":"Rev Saude Publica"},{"issue":"s01","key":"2735_CR11","first-page":"eAPESPE01954","volume":"36","author":"I Eshriqui","year":"2023","unstructured":"Eshriqui I, Cordeiro L, Almeida LY, Sousa AAF, Paiva Neto FT, Vesga-Varela AL, Teodoro CS, et al. Using implementation science to evaluate mental health intervention: methodological proposal. Acta Paul Enferm. 2023;36(s01):eAPESPE01954.","journal-title":"Acta Paul Enferm"},{"issue":"1","key":"2735_CR12","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1016\/j.jad.2013.05.054","volume":"151","author":"AR Brunoni","year":"2013","unstructured":"Brunoni AR, Nunes MA, Figueiredo R, Barreto SM, da Fonseca Mde J, Lotufo PA, Bense\u00f1or IM. Patterns of benzodiazepine and antidepressant use among middle-aged adults. The Brazilian longitudinal study of adult health (ELSA-Brasil). J Affect Disord. 2013;151(1):71\u20137.","journal-title":"J Affect Disord"},{"key":"2735_CR13","doi-asserted-by":"crossref","unstructured":"Freire M, de Silva BO, da BGC, Bertoldi AD, Fontanella AT, Mengue SS, Ramos LR, Tavares NUL, Pizzol T da,. SD, Arrais PSD, Farias MR, Luiza VL, Oliveira MA, Menezes A. M. B. Benzodiazepines utilization in Brazilian older adults: a population-based study. Revista De Sa\u00fade P\u00fablica. 2022;56:10.","DOI":"10.11606\/s1518-8787.2022056003740"},{"issue":"1","key":"2735_CR14","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1590\/1516-4446-2018-0088","volume":"41","author":"CS Madruga","year":"2019","unstructured":"Madruga CS, Paim TL, Palhares HN, Miguel AC, Massaro LTS, Caetano R, Laranjeira RR. Prevalence of and pathways to benzodiazepine use in Brazil: the role of depression, sleep, and sedentary lifestyle. Braz J Psychiatry. 2019;41(1):44\u201350.","journal-title":"Braz J Psychiatry"},{"key":"2735_CR15","doi-asserted-by":"publisher","first-page":"3243","DOI":"10.1590\/1413-812320152010.14612014","volume":"20","author":"PHA da Costa","year":"2015","unstructured":"da Costa PHA, Colugnati FAB, Ronzani TM. Mental health services assessment in Brazil: systematic literature review. Cien Saude Colet. 2015;20:3243\u201353.","journal-title":"Cien Saude Colet"},{"issue":"4","key":"2735_CR16","doi-asserted-by":"crossref","first-page":"1127","DOI":"10.1590\/S0103-73312014000400008","volume":"24","author":"C de Rosalmeida Dantas","year":"2014","unstructured":"de Rosalmeida Dantas C, Oda AMGR. Mapping of inquiries in mental health care in Brazil (2004\u20132013). Physis. 2014;24(4):1127.","journal-title":"Physis"},{"key":"2735_CR17","doi-asserted-by":"crossref","unstructured":"Coelho VAA, da Gama CAP, Andrade LI, e, Silva MA e, Guimar\u00e3es DA, de Azevedo Guimar\u00e3es EA et al. Community mental health care network: an evaluative approach in a Brazilian state. Int J Ment Health Syst. 2023;17(1):9.","DOI":"10.1186\/s13033-023-00578-7"},{"key":"2735_CR18","unstructured":"PLANIFICA SUS. SMAPS Technical Note 002\/2023 - SMAPS HCP\u2013Performance Index (iHCP\u2013Performance). Available from: https:\/\/planificasus.com.br\/arquivo-download.php?hash=83ef73dcb14497e2a75ac8a6a604a851072cd21e_t=1689192126_type=biblioteca. Accessed at: 05 mar. 2024."},{"key":"2735_CR19","unstructured":"Sociedade Beneficente Israelita Brasileira Albert Einstein. NOTA, T\u00c9CNICA PARA ORGANIZA\u00c7\u00c3O DA REDE DE, ATEN\u00c7\u00c3O \u00c0 SA\u00daDE COM FOCO NA ATEN\u00c7\u00c3O PRIM\u00c1RIA \u00c0 SA\u00daDE E NA ATEN\u00c7\u00c3O AMBULATORIAL ESPECIALIZADA \u2013 SA\u00daDE MENTAL. S\u00e3o Paulo; 2021. Available from: https:\/\/planificasus.com.br\/arquivo-download.php?hash=6a7525c15b6d16a7d0733c869878e881f4365db6_t=1698777507_type=biblioteca"},{"key":"2735_CR20","unstructured":"Salgado MA, Fortes SLCL. Mental health indicators in primary healthcare: assessment of the quality of access through case detection capacity. Cad Saude Publica. 2021;37."},{"issue":"4","key":"2735_CR21","doi-asserted-by":"publisher","first-page":"821","DOI":"10.1590\/S1413-81232012000400002","volume":"17","author":"OY Tanaka","year":"2012","unstructured":"Tanaka OY, Tamaki EM. The role of evaluation in decision-making in the management of health services. Cien Saude Colet. 2012;17(4):821.","journal-title":"Cien Saude Colet"},{"key":"2735_CR22","volume-title":"MI-mhGAP: manual de Interven\u00e7\u00f5es para transtornos mentais, neurol\u00f3gicos e por uso de \u00e1lcool e outras drogas na rede De aten\u00e7\u00e3o b\u00e1sica \u00e0 sa\u00fade","author":"WH Organization","year":"2018","unstructured":"Organization WH. MI-mhGAP: manual de Interven\u00e7\u00f5es para transtornos mentais, neurol\u00f3gicos e por uso de \u00e1lcool e outras drogas na rede De aten\u00e7\u00e3o b\u00e1sica \u00e0 sa\u00fade. Bras\u00edlia- DF: Vers\u00e3o; 2018."},{"key":"2735_CR23","doi-asserted-by":"publisher","first-page":"e00097718","DOI":"10.1590\/0102-311x00097718","volume":"35","author":"C Fegadolli","year":"2019","unstructured":"Fegadolli C, Varela NMD, de Carlini EL. Uso E abuso de benzodiazep\u00ednicos na aten\u00e7\u00e3o prim\u00e1ria \u00e0 sa\u00fade: pr\u00e1ticas profissionais no Brasil e em Cuba. Cad Saude Publica. 2019;35:e00097718.","journal-title":"Cad Saude Publica"},{"issue":"4","key":"2735_CR24","doi-asserted-by":"publisher","first-page":"717","DOI":"10.1590\/S0034-89102008005000034","volume":"42","author":"MC Lima","year":"2008","unstructured":"Lima MC, Menezes PR, Carandina L, Cesar CL, Barros MB, Goldbaum M. Common mental disorders and the use of psychoactive drugs: the impact of socioeconomic conditions. Rev Saude Publica. 2008;42(4):717\u201323.","journal-title":"Rev Saude Publica"},{"key":"2735_CR25","doi-asserted-by":"crossref","unstructured":"Ballester DA, Filippon AP, Braga C, Andreoli SB. The general practitioner and mental health problems: challenges and strategies for medical education. Sao Paulo Med J. 2005;2;123(2):72\u20136.","DOI":"10.1590\/S1516-31802005000200008"},{"key":"2735_CR26","doi-asserted-by":"publisher","first-page":"399","DOI":"10.1590\/S0102-311X2007000200016","volume":"23","author":"GW Campos","year":"2007","unstructured":"Campos GW, de Domitti S. Apoio matricial e equipe de refer\u00eancia: uma metodologia para gest\u00e3o do trabalho interdisciplinar em sa\u00fade. Cad Saude Publica. 2007;23:399\u2013407.","journal-title":"Cad Saude Publica"},{"key":"2735_CR27","doi-asserted-by":"crossref","unstructured":"Amaral CEM, Treichel CA dos, Francisco S, Onocko-Campos PMSB. RT. Assist\u00eancia \u00e0 sa\u00fade mental no Brasil: estudo multifacetado em quatro grandes cidades. Volume 37. Cadernos de Sa\u00fade P\u00fablica. scielo; 2021.","DOI":"10.1590\/0102-311x00043420"}],"container-title":["BMC Primary Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12875-025-02735-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12875-025-02735-y\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12875-025-02735-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,26]],"date-time":"2025-02-26T07:57:16Z","timestamp":1740556636000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcfampract.biomedcentral.com\/articles\/10.1186\/s12875-025-02735-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,26]]},"references-count":27,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["2735"],"URL":"https:\/\/doi.org\/10.1186\/s12875-025-02735-y","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-4224979\/v1","asserted-by":"object"}]},"ISSN":["2731-4553"],"issn-type":[{"value":"2731-4553","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,26]]},"assertion":[{"value":"5 April 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"31 January 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 February 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was approved by the Hospital Israelita Albert Einstein Ethics Committee (HIAE\/CAAE: 12395919.0.0000.0071) and conducted in accordance with the Declaration of Helsinki. Participation was conditional on the completion and signing of the Informed Consent Form.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"56"}}