American Economic Journal:
Economic Policy
ISSN 1945-7731 (Print) | ISSN 1945-774X (Online)
The Effects of a Large-Scale Mental Health Reform: Evidence from Brazil
American Economic Journal: Economic Policy
vol. 16,
no. 3, August 2024
(pp. 257–89)
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.Citation
Dias, Mateus, and Luiz Felipe Fontes. 2024. "The Effects of a Large-Scale Mental Health Reform: Evidence from Brazil." American Economic Journal: Economic Policy, 16 (3): 257–89. DOI: 10.1257/pol.20220246Additional Materials
JEL Classification
- H51 National Government Expenditures and Health
- I12 Health Behavior
- I18 Health: Government Policy; Regulation; Public Health
- O15 Economic Development: Human Resources; Human Development; Income Distribution; Migration
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