Abstract
In this article we describe the characteristics of the treatment negotiation process with medications at the Centros de Atenção Psicossocial (CAPS) in four major Brazilian municipalities. A structured questionnaire was applied to 1,630 CAPS users in the cities of Campinas, Fortaleza, Porto Alegre and São Paulo. Most users undergoing treatment at the CAPS did not start using medication at the CAPS, but already in the first contact with health services. Almost all users were medicated when starting treatment at CAPS and most of them were medicated at the first visit. Between 55.2% and 40.7% (depending on the municipality) reported not having received information on the time needed to use the medication. A very high proportion of users reported having changed the dose of the medication alone (40.5% to 28.7%) or having been medicated against their will (35.7% to 15.6%), which indicates limits on building consensus among staff, users and families on the use of medication. CAPS users participate little in the medication decision process. There are problems from the provision of information to problems in building consensus involving the introduction and continued use of the drug.
Key words:
Mental health services; Assessment; Psychotropic drugs; Shared decision-making; Mixed studies