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The Effects of a Large-Scale Mental Health Reform: Evidence from Brazil

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  • Mateus Dias
  • Luiz Felipe Fontes

Abstract

This paper studies the Brazilian Psychiatric Reform, which reorganized the public mental health care provision by introducing mental health centers (CAPS) as a community-based substitute for inpatient care. Our research design exploits the rollout of CAPS in a difference-in-differences framework. We show that these centers increased outpatient mental health care production and reduced psychiatric hospitalizations. These reductions were more pronounced for long-stay admissions and among patients with schizophrenia. We find that the savings implied by fewer admissions do not offset the cost of the policy. Also, the reform did not reduce mental health mortality and it increased violent crimes.

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  • Mateus Dias & Luiz Felipe Fontes, 2024. "The Effects of a Large-Scale Mental Health Reform: Evidence from Brazil," American Economic Journal: Economic Policy, American Economic Association, vol. 16(3), pages 257-289, August.
    • Handle: RePEc:aea:aejpol:v:16:y:2024:i:3:p:257-89
    DOI: 10.1257/pol.20220246
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    Cited by:

    1. Matías Mrejen & Rudi Rocha, 2021. "Hiring Mental Health Professionals: Evidence from a Large-Scale Primary Care Policy in Brazil," Institutional Studies 03, Instituto de Estudos para Políticas de Saúde.

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    More about this item

    JEL classification:

    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • O15 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - Economic Development: Human Resources; Human Development; Income Distribution; Migration

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