Mental health and public policies implemented in the Northeast of Brazil: A systematic review with meta-analysis

Abstract

Introduction: Studies about mental disorders are very rare in the Northeast of Brazil, especially when psychopathologies in children and adolescents are considered. The consequence is a small availability of data and an absence of a real epidemiological profile. Methods: This is a systematic review with meta-analysis, following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) protocol, in the period from 2003 to 2015, using the databases LILACS, SciELO and BVS. The analysis comprised the keywords ‘models of primary and secondary healthcare in mental health’, ‘psychiatric reform’ and ‘policies and services in mental health’, using the Boolean operator ‘# AND’. Original texts based on secondary data from the Hospital Information System of the Brazilian Unified Health System were also included via the Citizen Electronic Record System, Instituto Brasileiro de Geografia e Estatística, and Ministry of Health. Grey literature was used by means of hand searching. Results: A combined analysis of the strategies mentioned in the analyzed articles shows a combined odds ratio of 1.291 (confidence interval (CI) = 1.054–1.582), thus it demonstrates the efficacy of using such strategies in the elaboration of institutional apparatus in mental health. The p-value of the chi-square distribution resulted in .9753, which does not reject the hypothesis of association between strategies in mental health and possible development of institutional apparatus in mental health. Conclusions: A combined analysis of all strategies mentioned in the analyzed studies shows efficacy of using strategies to elaborate institutional apparatus in mental health.