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Columns   |    
Global Mental Health Reforms: Challenges in Developing a Community-Based Program for Maltreated Children and Adolescents in Brazil
Sandra Scivoletto, Ph.D.; Mauro Vitor de Medeiros Filho; Elina Stefanovics, Ph.D.; Robert A. Rosenheck, M.D.
Psychiatric Services 2014; doi: 10.1176/appi.ps.201300439
View Author and Article Information

Dr. Scivoletto and Mr. Medeiros Filho are with The Equilibrium Program, Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, Brazil (e-mail: sscivoletto@gmail.com). Dr. Stefanovics and Dr. Rosenheck are with the Department of Psychiatry, Yale University, New Haven, Connecticut. José Miguel Caldas de Almeida, M.D., and Matt Muijen, M.D., Ph.D., are editors of this column.

Copyright © 2014 by the American Psychiatric Association

Abstract

This column describes the planning and development of The Equilibrium Program (TEP) for multiply traumatized and neglected children and adolescents with mental and general medical problems in São Paulo, Brazil. The program is a partnership between university faculty, various service providers, the courts, and the city government. In the first step, child psychiatry faculty from the University of São Paulo visited central-city areas and group shelters to talk to street youths to better understand their needs. A nearby community sports center building was chosen to be a center where youths could access services and engage in recreational activities and where the work of family integration could be facilitated. A multidisciplinary team conducts an in-depth assessment and creates an intervention plan, overseen by a case manager. Challenges to implementing such programs are discussed.

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