Care Pathways Between Primary Health Care and Psychosocial Care Centers for Users With Mental Health Needs in a Brazilian Urban District
1
Department of Life Sciences, Bahia State University, Salvador, Brazil
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
BACKGROUND:
Mental health care in Brazil is organized through the Psychosocial Care Network, which prioritizes community-based services and coordination between Primary Health Care and Psychosocial Care Centers.1,2 Despite this model, users with mental health needs frequently experience fragmented care, weak interservice communication, and ineffective referral and counter-referral processes.3 Understanding how care pathways function in everyday practice is essential to strengthening integrated and continuous mental health care within the public health system.4
METHODS:
This qualitative study was conducted in a Health District in Salvador, Bahia, Brazil. Semi-structured interviews were carried out with Primary Health Care professionals, Psychosocial Care Center professionals, and adult users with mental health needs. Participants were selected based on theoretical saturation. Data were analyzed using thematic content analysis, focusing on care pathways, interservice communication, referral and counter-referral mechanisms, and shared care practices.5
RESULTS:
The findings revealed substantial weaknesses in communication between Primary Health Care teams and Psychosocial Care Centers, leading to fragmented care trajectories and frequent circulation of users across services without continuity of follow-up. Professionals reported work overload, limited time for case discussions, and restricted access to matrix support activities. Prescription renewal emerged as a recurrent practice, often replacing comprehensive clinical assessments and non-pharmacological interventions. Nevertheless, strong bonds between users and Primary Health Care professionals were identified as key facilitators of longitudinal care. Remote matrix support meetings were highlighted as a feasible strategy to strengthen interprofessional dialogue and shared responsibility.
CONCLUSIONS:
Care pathways for users with mental health needs remain fragile due to insufficient service coordination and limited implementation of shared care strategies. Strengthening communication, expanding matrix support, and adopting individualized therapeutic projects are essential to reducing fragmentation and promoting comprehensive, continuous mental health care.
Mental health care in Brazil is organized through the Psychosocial Care Network, which prioritizes community-based services and coordination between Primary Health Care and Psychosocial Care Centers.1,2 Despite this model, users with mental health needs frequently experience fragmented care, weak interservice communication, and ineffective referral and counter-referral processes.3 Understanding how care pathways function in everyday practice is essential to strengthening integrated and continuous mental health care within the public health system.4
METHODS:
This qualitative study was conducted in a Health District in Salvador, Bahia, Brazil. Semi-structured interviews were carried out with Primary Health Care professionals, Psychosocial Care Center professionals, and adult users with mental health needs. Participants were selected based on theoretical saturation. Data were analyzed using thematic content analysis, focusing on care pathways, interservice communication, referral and counter-referral mechanisms, and shared care practices.5
RESULTS:
The findings revealed substantial weaknesses in communication between Primary Health Care teams and Psychosocial Care Centers, leading to fragmented care trajectories and frequent circulation of users across services without continuity of follow-up. Professionals reported work overload, limited time for case discussions, and restricted access to matrix support activities. Prescription renewal emerged as a recurrent practice, often replacing comprehensive clinical assessments and non-pharmacological interventions. Nevertheless, strong bonds between users and Primary Health Care professionals were identified as key facilitators of longitudinal care. Remote matrix support meetings were highlighted as a feasible strategy to strengthen interprofessional dialogue and shared responsibility.
CONCLUSIONS:
Care pathways for users with mental health needs remain fragile due to insufficient service coordination and limited implementation of shared care strategies. Strengthening communication, expanding matrix support, and adopting individualized therapeutic projects are essential to reducing fragmentation and promoting comprehensive, continuous mental health care.
| eISSN: | 2654-1459 |
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