RESUMO
The purpose of this paper is to describe the development and initial accomplishments of a training program of young leaders in community mental health research as part of a Latin American initiative known as RedeAmericas. RedeAmericas was one of five regional 'Hubs' funded by the National Institute of Mental Health (NIMH) to improve community mental health care and build mental health research capacity in low- and middle-income countries. It included investigators in six Latin American cities - Santiago, Chile; Medellín, Colombia; Rio de Janeiro, Brazil; and Córdoba, Neuquén, and Buenos Aires in Argentina - working together with a team affiliated with the Global Mental Health program at Columbia University in New York City. One component of RedeAmericas was a capacity-building effort that included an Awardee program for early career researchers in the mental health field. We review the aims of this component, how it developed, and what was learned that would be useful for future capacity-building efforts, and also comment on future prospects for maintaining this type of effort.
RESUMO
BACKGROUND: The number of homeless people of any country is a major social and health issue, but to date only a few descriptive and focused studies have been undertaken in Brazil on the matter. METHOD: In order to fill this gap, a cross-sectional study was carried out in a random representative sample (n=330) out of 1,977 homeless people lodged in the five public hostels of the Rio de Janeiro metropolitan area. Full data were collected by two trained researchers in a face-to-face interview with 319 (96.7 %) out of the 330 lodgers, using the CIDI (Composite International Development Interview) to assess psychiatric diagnosis. RESULTS: The main findings concern prevalence rate of major mental illness, which was 19.4% for the 12 months before data collection, and 22.6% lifetime prevalence rate. Other 12-month prevalence rates were 31% for alcohol abuse/dependence, 4.1% for drug abuse/addiction, 15% for severe cognitive impairment, and 49.2% for any mental disorder. The rate was 65.2% when organic mental disorders were added. Moreover, 23.9% of the sampled lodgers reported previous psychiatric admission. Their demographic characteristics were a mean age of 44.8 years old, 75.8% of them were male, 78.9% were single, 94.7% had a low level of schooling, and 79.2% were long-term unemployed. CONCLUSIONS: This study demonstrates the high rates of psychiatric morbidity in the homeless, but these rates are exceeded by the apparent poverty and illiteracy of the sample. Given the lack of delivery of community services now in Brazilian cities, this group is likely to be marginalized. Some special teams to assess the hostel residents need to be created.