Pathways in Mental Health

Adolescents Mapping Mental Health Women

Development: March 2020 to June 2021

Release: June 2021

Partner: Veredas Institute

Results: 1708 downloads


The Pathways in Mental Health report, conceived by the Cactus Institute to provide society and the mental health ecosystem with a robust base of evidence and data that would offer a broader and deeper look at mental health in Brazil, was produced in partnership with the Veredas Institute and published in June 2021.

The report, based on an extensive survey of the existing evidence that was carried out between March and December 2020, offers a complex understanding of the field of mental health, including its history and structure in Brazil. To carry out the survey, we considered the consensus produced by international organizations and Brazil’s own experience – which for decades has served as a model for building community-care strategies around the world.

We also sought to include the knowledge of specialists from various fields: sociology, public administration, psychology, medicine and mental health. On this basis, the report details seven main strategies for action, challenges and opportunities. They are: advocacy, empowerment, social support, leadership and governance, the health system, mental health actions and the information system, scientific data and research.

This project marks the Cactus Institute’s first major institutional effort as an entity that gathers and mobilizes civil society in order to pave the way for a new mental health culture in Brazil. Further, Pathways in Mental Health is part of one of our major commitments: to generate and disseminate quality knowledge through open, informative, empathetic and less polarized debate. 

The physical version of the report was delivered to public policy makers, representatives of international organizations, members of the third and private sectors and opinion makers, among other groups.

Available for download from our Library, the Pathways in Mental Health report has become a source of research and consultation for communicators, opinion makers, various organizations and researchers in the area of mental health.  

READ THE COMPLETE REPORT “CAMINHOS EM SAÚDE MENTAL” (Pathways in Mental Health) (only available in Portuguese)

Some of the main highlights brought together by the study are:

Mental health as a global public health issue:

of all people in the world will experience a mental illness during their lifetime
but only 10% will have access to treatment. In 2015, the proportion of the global population with depression was 4.4%, or 332 million people;

Global burden of disease:

Mental and addictive disorders caused the largest global burden of disease in terms of years lived with disability (YLD), representing 32.4% of all years. They caused 13% of all global burden of disease as measured in DALYs, equivalent to cardiovascular and circulatory diseases.

Public and private investments:

Mental health expenditure accounted for less than 2% of government budgets for health, and the situation is even worse in low- and middle-income countries.
In Brazil, health and sports accounted for only 4% of the total BRL2.5 billion of Private Social Investment in 2019.


About 50% of all mental illnesses begin by the age of 14 and 75% by the age of 24, however, the majority of cases (80%) go undetected or untreated



One in five women experience common mental disorders and the rate of depression is, on average, twice the rate of depressed men, and it can be more persistent among women.

Physical and mental overload are identified as two of the main risk factors: in groups with high domestic overload, the number of women with common mental disorders goes up to one in two women.

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