Building a State-Level Psychosocial Care System for Public Schools in Brazil: Institutional Design, Governance, and Data-Driven Implementation
1
Public Policy Department, Institute for Health Policy Studies (IEPS), Rio de Janeiro, Brazil
2
Institutional Affairs Department, Institute for Health Policy Studies (IEPS), Rio de Janeiro, Brazil
3
School Psychosocial Care Unit (UAPSE), Pernambuco State Department of Education, Recife, Brazil
Popul. Med. 2026;8(Supplement Supplement 1):A2607
ABSTRACT
BACKGROUND:
Psychological distress among children and adolescents increasingly affects lives in Brazil and globally, highlighting the limits of fragmented and individual-centered responses. Although schools are strategic settings for well-being and psychosocial care, many countries lack subnational systems to implement national legal frameworks into coordinated action. In Brazil, Federal Law No. 14819/2024 established a national school psychosocial care policy, whose effectiveness depends on intersectoral governance and subnational capacity. In response, the State of Pernambuco initiated a State-Level Psychosocial Care System for Schools, covering approximately 1069 public schools.
METHODS:
This study presents an analytical implementation report of a state-level public policy in Pernambuco, developed with technical support from the Institute for Studies on Health Policy (IEPS) and the Child Mind Institute (CMI). This study presents an analytical implementation report of a state-level public policy, structured around three core axes: governance, including formal regulations, technical guidelines, and role definition across levels; psychosocial care and intersectoral response in schools, through standardized protocols and agreed pathways; and monitoring and strategic use of data to support policy follow-up and decision-making.
RESULTS:
Implementation produced concrete institutional advances: enactment of state-level ordinances formalizing rules and guidelines for the Entrelaços Project; publication of Brazil’s first technical guidelines regulating school-based psychologists and social workers; delivery of the country’s first training course to implement Federal Law No. 14819/2024; regular operation of an Intersectoral Mental Health Promotion Committee; and integration of mental health indicators into SAEPE (Pernambuco’s statewide educational assessment), based on the RCADS-11, guiding territorial prioritization, professional training, and care pathways.
CONCLUSIONS:
The experience demonstrates how subnational states can play a central role in coordinating psychosocial care in fragmented federative contexts, such as Brazil, through intersectoral coordination, alignment across government levels, strengthening local institutional capacities, the establishment of technical norms and guidelines, and the training of technical and school-based teams.
Psychological distress among children and adolescents increasingly affects lives in Brazil and globally, highlighting the limits of fragmented and individual-centered responses. Although schools are strategic settings for well-being and psychosocial care, many countries lack subnational systems to implement national legal frameworks into coordinated action. In Brazil, Federal Law No. 14819/2024 established a national school psychosocial care policy, whose effectiveness depends on intersectoral governance and subnational capacity. In response, the State of Pernambuco initiated a State-Level Psychosocial Care System for Schools, covering approximately 1069 public schools.
METHODS:
This study presents an analytical implementation report of a state-level public policy in Pernambuco, developed with technical support from the Institute for Studies on Health Policy (IEPS) and the Child Mind Institute (CMI). This study presents an analytical implementation report of a state-level public policy, structured around three core axes: governance, including formal regulations, technical guidelines, and role definition across levels; psychosocial care and intersectoral response in schools, through standardized protocols and agreed pathways; and monitoring and strategic use of data to support policy follow-up and decision-making.
RESULTS:
Implementation produced concrete institutional advances: enactment of state-level ordinances formalizing rules and guidelines for the Entrelaços Project; publication of Brazil’s first technical guidelines regulating school-based psychologists and social workers; delivery of the country’s first training course to implement Federal Law No. 14819/2024; regular operation of an Intersectoral Mental Health Promotion Committee; and integration of mental health indicators into SAEPE (Pernambuco’s statewide educational assessment), based on the RCADS-11, guiding territorial prioritization, professional training, and care pathways.
CONCLUSIONS:
The experience demonstrates how subnational states can play a central role in coordinating psychosocial care in fragmented federative contexts, such as Brazil, through intersectoral coordination, alignment across government levels, strengthening local institutional capacities, the establishment of technical norms and guidelines, and the training of technical and school-based teams.
| eISSN: | 2654-1459 |
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