CFM considers PACs unethical to care for the mentally ill
DOI:
https://doi.org/10.25118/2763-9037.2011.v1.976Keywords:
ambulatory care, mentally ill personsAbstract
The first Opinion of 2011 published by the Federal Council of Medicine (CFM) concerns mental health. The document considers two ordinances to be unethical, numbers 224/92 and 336/02, from the Ministry of Health, which establish standards and guidelines for outpatient care for mentally ill patients. According to Opinion No. 1, the ordinances are in disagreement with the CFM regulations, as they do not determine the full-time stay of psychiatrists in CAPs (Psychosocial Care Centers) Ille AD Ile AD IIl, which provide reception services 24 hours, including on holidays and weekends. For the vice-president of the CFM and rapporteur of the opinion, Emmanuel Fortes, the word reception distorts the real meaning of the procedure that is to admit, according to Law 10.216/01, generating doubt and “vulnerabilizing the safety of patient care and the practice of the medical act”. “In addition to the absence of the psychiatrist, the CAPs Ille AD Ile Ill are admitting patients, an action that is not foreseen in the Ministry of Health regulations”, explained Emmanuel Fortes. For this reason, the CFM has already notified the Mental Health Coordination, asking that measures be taken to ensure the presence of psychiatrists in CAPs that provide 24-hour care and recommended that the Regional Medicine Councils (CRMs) monitor state CAPs to check whether those that provide 24-hour care have the necessary infrastructure to care for patients, such as ambulances for patient travel, medication and a psychiatrist on site, in compliance with the centers' opening hours. Also according to the vice-president, it will be up to the CRMs to establish the necessary deadlines for the State Health Departments to adopt the necessary measures to keep the CAPs in operation, in accordance with the Public Ministry's ordinance. After communication and deadlines have been established, if no action is taken, the CFM may contact the Public Prosecutor's Office and suggest closing the location. According to the Ministry of Health, there are currently 1,620 CAPs in the country. Of this total, 761 are CAPs |, providing quick service, for consultations and prescription renewal, established in cities with up to 70 thousand inhabitants. CAPs III, which provide for patient reception and are installed in cities with more than 150 thousand inhabitants, are only 55 across the country, with ten states, Acre, Amapá, Roraima, Rondônia, Tocantins, Alagoas, Goiás, Minas Gerais, Espírito Santo, Rio Grande do Sul and the Federal District do not have CAPs III. See CFM Opinion No. 01 below.
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Copyright (c) 2011 Emmanuel Fortes Silveira Cavalcanti
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