Key features and current challenges of the Brazilian Psychosocial Care Centers for alcohol and other drugs (CAPS-AD)

This paper examines the evolution and current challenges of the Brazilian Psychosocial Care Centers for Alcohol and other Drugs (CAPS-ADs), central to Brazil's mental health reform. Established within the broader Psychosocial Care Network (RAPS) in 2002, CAPS-AD represents a shift from hospital-centric to community-based care for mental health and substance dependency. Synthesizing 39 peer-reviewed articles, the study explores CAPS-AD's operational characteristics, effectiveness and limitations. The model is distinguished by its interdisciplinary approach, open-door policy, and focus on social reintegration, providing continuous access to specialized care. Key features include singular therapeutic plans, harm reduction strategies and integration with primary care. The CAPS-AD III modality, offering 24-hour care, highlights the model's adaptability. Despite its strengths, the CAPS-ADs face challenges such as user dissatisfaction with rigid therapeutic activities, limited autonomy and inadequate participation in care planning. Structural deficiencies, particularly in resource-limited regions and the persistence of traditional biomedical approaches further hinder quality care. Additional barriers include insufficient attention to gender-specific needs, age-appropriate care and the stigmatization of substance users and professionals. Addressing these challenges through structural reforms, enhanced training, and a more integrated, personalized, and stigma-free approach is essential to fully realize the potential of CAPS-AD and advance equitable mental health care in Brazil.