Evaluation of a Brief Telepsychotherapy Service Offered in a Brazilian Capital

Abstract

Objective:

To evaluate a brief telepsychotherapy service within the Brazilian Unified Health System in a Brazilian capital (April 2024–April 2025), analyzing its functioning, outcomes, and contribution to access in primary health care (PHC).

Methods:

A quantitative descriptive study using secondary data from the service’s regulatory system and records. Individuals ≥18 years of age with a therapeutic outcome during the period were included. Descriptive, bivariate (chi-square, Welch’s t, and Mann–Whitney), and binary logistic regression analyses were performed.

Results:

One hundred and ninety-three users participated, predominantly women (88.1%) and adults aged 25–59 years (80.3%). The outcome was discharge in 37.8% and discontinuation in 62.2%. Reasons for discontinuation included absences (30.6%), unsuitability (13.5%), at the patient’s request (12.4%), and referral to the psychosocial care center (5.7%). In the regulatory system, “Mental and behavioral disorders” (ICD F00–F99; n = 126) predominated, with frequent use of ICD Z codes, suggesting diagnostic difficulties in PHC. Most teleconsultations occurred in urban units (97.2%), with 77.7% of requests coming from units with multiprofessional teams in primary health care (eMULTI); the average attendance rate was 58.75%. In bivariate analyses, the outcome was associated with the presence of eMULTI (p = 0.0398) and the ICD chapter (p = 0.0056). The attendance rate differed significantly between high-level and low-level attendance (p < 0.0001).

Conclusion:

Telepsychology is a relevant strategy to expand access and reduce unmet demand in PHC. However, challenges regarding adherence and continuity persist. Effectiveness depends on clear workflows, qualified teams, and engagement and integration strategies between PHC and specialized services.