SYSTEMATIC REVIEW ON EFFECTIVENESS, OUTCOMES AND IMPLEMENTATION OF MENTAL HEALTH IN PRIMARY CARE

SYSTEMATIC REVIEW ON THE EFFECTIVENESS, OUTCOMES, AND IMPLEMENTATION OF MENTAL HEALTH IN PRIMARY CARE.

Abstract

The integration of mental health into primary care constitutes a priority strategy in face of the growing prevalence of mental disorders and the limitations of the traditional specialized model. This systematic review synthesized evidence on the effectiveness and outcomes of integration models published between 2013 and 2025. Searches were conducted in nine databases without language restrictions, including studies evaluating Collaborative Care, Matrix Support, co-location, and case management. Of the 96 records identified, 37 articles were included and categorized into three thematic groups. Results reveal marked methodological asymmetry: Collaborative Care presents decades of consolidated evidence with meta-analyses demonstrating symptom reduction and cost-effectiveness, while Brazilian Matrix Support relies predominantly on descriptive qualitative studies. Three critical gaps were identified: absence of direct comparative studies between models, neglect of severe mental disorders, and scarcity of economic analyses in resource-limited settings, hampering evidence-based recommendations for public policies.