Primary Care and Children's Mental Health in Brazil

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dc.contributor.author Paula, Cristiane Silvestre de [UNIFESP]
dc.contributor.author Nakamura, Eunice [UNIFESP]
dc.contributor.author Wissow, Lawrence
dc.contributor.author Bordin, Isabel Altenfelder Santos [UNIFESP]
dc.contributor.author Nascimento, Rosimeire do [UNIFESP]
dc.contributor.author Leite, Álvaro Jorge Madeiro [UNIFESP]
dc.contributor.author Cunha, Antonio
dc.contributor.author Martin, Denise [UNIFESP]
dc.date.accessioned 2018-06-15T11:14:53Z
dc.date.available 2018-06-15T11:14:53Z
dc.date.issued 2009-07-01
dc.identifier http://dx.doi.org/10.1016/j.acap.2009.02.006
dc.identifier.citation Academic Pediatrics. New York: Elsevier Science Inc, v. 9, n. 4, p. 249-255, 2009.
dc.identifier.issn 1876-2859
dc.identifier.uri http://repositorio.unifesp.br/11600/41965
dc.description.abstract Objective.-Primary care offers opportunities to expand children's access to mental health (MH) services, but a given practice's community context and staff attitudes may influence which integration models are feasible. The aim of this study was to explore the possibility of using community-based primary care to increase access to MH services in low-income communities in Brazil.Methods.-A qualitative study was undertaken using focus groups with adolescents aged 11 to 16 (n = 46), parents (n = 40), and primary care clinicians and staff (n = 52) from public-sector health centers in 6 low-income Brazilian communities chosen for their geographic diversity.Results.-Parents felt they had little support in parenting and attributed much of their children's behavior and mood problems to life in violent, poor communities. Parents thought that primary care could potentially be a source of MH care, but that clinicians often seemed rushed or uninterested. Clinicians classified many child problems as issues with parenting rather than MH. Nonprofessional staff was more likely to be a source of support to parents, except at one center that had a truly integrated MH service. Adolescents reported little need for MH services.Conclusions.-Expanding the role of primary care in child MH may require close attention to how parents, adolescents, and clinicians define their problems and on the causes to which they attribute them. These factors interact with differences in how centers organize MH care, and the extent to which they take advantage of patient interactions with nonprofessional staff. en
dc.description.sponsorship INCLEN Trust
dc.format.extent 249-255
dc.language.iso eng
dc.publisher Elsevier B.V.
dc.relation.ispartof Academic Pediatrics
dc.rights Acesso restrito
dc.subject Brazil en
dc.subject MH en
dc.subject primary health care en
dc.subject qualitative research en
dc.title Primary Care and Children's Mental Health in Brazil en
dc.type Artigo
dc.contributor.institution Univ Prebiteriana Mackenzie
dc.contributor.institution Universidade Federal de São Paulo (UNIFESP)
dc.contributor.institution Johns Hopkins Univ
dc.contributor.institution Univ Fed Ceara
dc.contributor.institution Universidade Federal do Rio de Janeiro (UFRJ)
dc.contributor.institution Univ Catolica Santos
dc.description.affiliation Univ Prebiteriana Mackenzie, Dev Disorder Post Grad Program, BR-01302907 Sao Paulo, Brazil
dc.description.affiliation Univ Fed Sao Paulo, Dept Psychiat, Sao Paulo, Brazil
dc.description.affiliation Univ Fed Sao Paulo, Dept Health Educ & Soc, Sao Paulo, Brazil
dc.description.affiliation Johns Hopkins Univ, Dept Hlth Behav & Soc, Baltimore, MD USA
dc.description.affiliation Univ Fed Ceara, Dept Pediat, Fortaleza, Ceara, Brazil
dc.description.affiliation Univ Fed Rio de Janeiro, Dept Pediat, Rio De Janeiro, Brazil
dc.description.affiliation Univ Catolica Santos, Publ Hlth Post Grad Program, Sao Paulo, Brazil
dc.description.affiliationUnifesp Univ Fed Sao Paulo, Dept Psychiat, Sao Paulo, Brazil
dc.description.affiliationUnifesp Univ Fed Sao Paulo, Dept Health Educ & Soc, Sao Paulo, Brazil
dc.identifier.doi 10.1016/j.acap.2009.02.006
dc.description.source Web of Science
dc.identifier.wos WOS:000275913200009



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