Mental health policies and changes in the emergency services profile

Objective To verify the modifications observed in a school hospital psychiatric emergency unit in Ribeirao Preto - SP, Brazil (EP-RP), due to alterations in the mental health policies implemented in this region. Methods Data about attendances was collected from university hospital files of the EP-RP, from 1988 to 1997 The following variables were studied: sex, age, origin and main diagnosis. Data about changes in mental health policies of the region was obtained from documents of the city and state departments of health. Results The yearly increase in the number of attendances followed the progressive involvement of EP-RP with the mental health service network, as the number of patients who looked for the service in 1995 was 2.3 times greater than in 1988. During this period, attendance at the EP-RP gave support to the modifications in the mental health policies in this region, resulting in a reduction of 654 psychiatry beds. In 1996 and 1997, a reduction of about 20% was observed in the total of attendance, as compared to 1995 result from an increase in the attendance capacity and number of the extra-hospital services. Since 1990, the EP-RP started to attend a higher proportion of older male patients, with drug dependency and psychotic disorders and a lower proportion of non-psychotic patients. Conclusions The changes observed in the EP-RP are related to modifications in the Ribeirao Preto region mental health policies, like the psychiatric beds control, installed in 1990, the reduction of psychiatric beds after 1993, and the creation and/or amplification of extra-hospital services, in 1995.