Effects of the implementation of matrix support in the operation of the community mental health network in a medium-sized Brazilian municipality: an ex-ante and ex-post evaluation

Abstract

Background The implementation of shared care strategies has been a global response to the challenge of the mental health care gap at primary levels of care and the lack of integration of health networks. In the Brazilian context, this perspective takes shape through Matrix Support, an interdisciplinary collaboration proposal that aims to improve mental health care, connecting specialized teams with Primary Care professionals. The objective of this study was to evaluate the impact of implementing matrix support in a medium-sized Brazilian municipality on the performance of the community mental health network. To this end, three main components were analyzed: (1) the characterization of the participants' profile, (2) the identification of therapeutic offers, and (3) the identification of clinical care received by participants in each of the services studied. Methods This is a cross-sectional study based on documents, ex-ante and ex-post, carried out through the analysis of medical records of participants linked to the three community mental health services in the city of Itatiba-SP. The study had two points of measurement (T0 and T1), with T0 carried out between May and July 2019 and T1 between November and December 2021. Descriptive statistical analysis was employed to estimate absolute and relative frequencies for each variable under investigation. Results The findings indicated a significant decrease in the number of patients whose diagnosis was unknown, suggesting an important reconfiguration of referral patterns within the health network. While there was a significant decrease in admissions due to spontaneous demand, there was a significant increase in referrals made through primary care. Furthermore, there was an increase in the number of patients receiving home care and patients receiving clinical healthcare, with a greater proportion of individuals having physical health issues included in their care plans. Conclusions The implementation of Matrix Support in the studied network may have contributed to the reorganization of the studied health network, with a greater focus on Primary Care and more comprehensive care for individuals requiring specialized mental health services.