Regional networking between services that provide mental health care in Brazil’s decentralized public health system is challenging, partly due to the simultaneous existence of services managed by municipal and state authorities and a lack of efficient and transparent mechanisms for continuous and updated communication between them. Since 2011, the Ribeirao Preto Medical School and the XIII Regional Health Department of the Sao Paulo state, Brazil, have been developing and implementing a web-based information system to facilitate an integrated care throughout a public regional mental health care network. After a profound on-site analysis, the structure of the network was identified and a web-based information system for psychiatric admissions and discharges was developed and implemented using a socio-technical approach. An information technology team liaised with mental health professionals, health-service managers, municipal and state health secretariats and judicial authorities. Primary care, specialized community services, general emergency and psychiatric wards services, that comprise the regional mental healthcare network, were identified and the system flow was delineated. The web-based system overcame the fragmentation of the healthcare system and addressed service specific needs, enabling: detailed patient information sharing; active coordination of the processes of psychiatric admissions and discharges; real-time monitoring; the patients’ status reports; the evaluation of the performance of each service and the whole network. During a 2-year period of operation, it registered 137 services, 480 health care professionals and 4271 patients, with a mean number of 2835 accesses per month. To date the system is successfully operating and further expanding. We have successfully developed and implemented an acceptable, useful and transparent web-based information system for a regional mental healthcare service network in a medium-income country with a decentralized public health system. Systematic collaboration between an information technology team and a wide range of stakeholders is essential for the system development and implementation.

Objective: to identify indicators that can be used in the management of Mental Health Services. Method: an integrative review in which we adopted the Population, Concept, and Context strategy to formulate the following Guiding Question: “Which indicators can be used for the management of mental health services?”. Results: a total of 22 articles were included and divided into two main groups: countries with initial high income (54%) as well as low- and middle-income countries (46%). We identified 5 studies that had experienced the use of indicators, 5 studies that had reported partial implementation, 9 studies that did not report use or implementation, 1 study on the indicator selection process, 1 as an implementation pilot, and a final study with a discussion for implementation. High-income countries also find it difficult to implement mental health indicators. The main difficulties in adopting the use of indicators are lack of basic mental health services, financial resources, legislation, political interest, and guidelines for its management. Conclusion: it is unusual to find a descriptive comparison of quality monitoring programs at the system level in the technical-scientific literature related to mental health indicators.

The Brazilian public health system instituted the mental health care networks in 2011. Thus, the goal of this paper is to describe the research methods used as basis for a proposal of an evaluation model of municipal and regional management of a Mental Health Care Network that comprises computerized information systems and specific indicators. Proposed steps include: Review of Brazilian legislation on management in mental health care networks, Formulation of questions about how is mental health care management in the region; Semi-structured interviews with stakeholders about the performance of the network; Study of existing indicators in mental health field used in universal public health systems; Selection of indicators for implementation and availability in a web information system; Monitoring the system's access to obtain indicators’ usage; Another set of semi-structured interviews to evaluate effective use of the provided indicators in management of mental health care. The results obtained will be evaluated qualitatively and quantitatively to compare the final overview with the initial one, regarding mental health care network management, and if the use of computerized indicators influenced it. The use of the proposed methods in specific localities will enable expansion of local knowledge improving management and health care quality

The rapid spread of COVID-19 have overwhelmed health systems, especially in the care of chronic disease such as tuberculosis and diabetes. The objective of the study was to analyze the magnitude and relevance of tuberculosis-diabetes and diabetes-COVID-19 comorbidities in spatial risk areas and their factors associated with unfavorable outcomes in the Brazilian population between 2020 and 2022. An ecological study was carried out in Brazilian municipalities. The population was composed by cases of tuberculosis-diabetes and diabetes-COVID-19 comorbidities, registered in the Influenza Epidemiological Surveillance Information System (SIVEP-GRIPE) and in DATASUS from 2020 to 2022. The Scan Statistics technique was used to identify spatial risk clusters. Binary logistic regression was then employed to understand the relationship between outcomes and comorbidities, considering clinical and sociodemographic variables. A total of 24,750 cases of tuberculosis-diabetes comorbidity were identified, which consisted of an incidence of 3.2 cases per 100,000 inhabitants. Risk clusters were identified in the Central-West and North regions. 303,210 cases of diabetes- COVID-19 comorbidity were identified, resulting in an incidence of 0.4 cases per 100,000 inhabitants. São Paulo-SP, Rio de Janeiro-RJ and Belo Horizonte-MG were the municipalities with the highest spatial risk of illness. The analysis of the spatial risk areas revealed distinct patterns in the geographic distribution of comorbidities. Based on the findings, it is concluded that comorbidities between tuberculosis and diabetes, as well as between COVID-19 and diabetes, represent significant challenges for public health in Brazil, deserving attention from health authorities and the scientific community.