Girls, I have depression and anxiety attacks so I’m well versed on Brazil’s mental health care.
Unfortunately my 20 years old son had a mental breakdown in August so I got to see Curitiba’s emergency mental health care approach first hand.
SUS is pretty much like Canada and NHS. It’s public, universal and paid with my taxes. You get a health card number showing ID and address proof. They used to give you the card with the number, nowadays you print it out of the government’s site or just give your name and birth date at reception.
You have two tiers of units: UBS (Basic Healthcare Unit - handles appointments with doctors, vaccinations and forwards you to CAPS, hospitalization etc as needed) and UPA (High priority Healthcare - handles emergency). My son went through UBS, the nurses forwarded him to CAPS but the date was in a week and he was suicidal. I told them that I was afraid of having him for a week at home in his present state of mind, one of us failing in keeping an eye on him and him acting on his urges - so we were forwarded to UPA. In UPA the nurses appraise level of emergency and give you colored paper wristbands according to the level of urgency. It’s always cramped and for low level situations you will wait for hours, but they saw my son quickly, bless them. THEN we had to wait. He was forwarded to hospitalization but you had to wait for the psychiatric hospital to open a spot and prepare a bed for him. He was in 24h care in UPA, but the wait for the hospital can take a week. We simply didn’t know how long we would wait. The doctors and nurses were amazing and kind, bureaucracy was the problem. We were lucky: although he spent a night in UPA (we parents took turns never leaving him alone) his internment was liberated the next day at midday. UPA handled everything my son needed for free, from IV drip with medication to food (four meals a day). Both us parents were allowed in the ambulance with him to the psychiatric hospital. There was another screening there, separated interviews with us and with my son so they can have a more balanced view of what’s happening. He has to read and sign up for voluntary internment and appoint a caretaker. They won’t intern against will.
He stayed there for a month, we had weekly meetings with the staff and two visits a week, so I got to see my son three times a week. He was discharged with forwarding documents to CAPS.
At CAPS yet another screening (yay!) and interviews so they could pair him with the most fitting psychiatrist and psychologist for his diagnosis. There’s two kinds of CAPS, by the way: CAPS AD (Alcohol and drugs) and CAPS TM (Mental health disorders),
My non-emergency mental health care is handled differently. I went to UBS, a nurse screened me and scheduled psychiatrist and psychologist. There’s an app that notifies me on appointments.
There’s government medication distributed inside UPA and UBS and some meds outside the list you have to buy. The list used to be very restrict - one antidepressant, one antipsychotic etc - but in latter years it expanded a lot. The units still have the more restricted meds list but the city has a central distributor of medications (CPM) that handles the new list.
In Brazil all colleges and universities that have a psychology degree must offer affordable therapy by law.