Intersectoral Collaboration Between Educational and Mental Health Services for Autistic Children and Adolescents in...

Intersectoral collaboration between education and mental health services is central to the care of autistic children and adolescents. However, recent literature indicates that evidence remains limited regarding how these collaborative arrangements are implemented in routine public services, particularly in low- and middle-income countries (LMICs). This study aimed to assess the intersectoral collaboration between Brazilian educational and mental health services for autistic children and adolescents and to examine the frequency and type of intersectoral contact.

An exploratory cross-sectional study was conducted in the municipal public education system of Niterói, a city in the Southeast region of Brazil. Participants included parents of 123 autistic children and adolescents, 49 teachers from mainstream education and specialized educational services (SES), and 24 health professionals. Data were collected using structured questionnaires with multi-informant reports. The instruments were specifically developed for the study and submitted to expert content-validation procedures. Analyses included descriptive statistics and, in a subsample of 51 matched cases with paired responses from teachers and health professionals, Cohen's kappa to assess agreement between reports.

Low levels of intersectoral collaboration were observed, characterized by infrequent contact, limited information exchange, and slight agreement between reports from teachers and health professionals (κ = 0.25; p = 0.01). Teachers were more likely to know where care was provided than to know which specialists were involved, while more than half of health professionals did not know which school the child attended.

In the investigated municipal network, care appeared fragmented, highlighting difficulties in translating intersectoral recommendations from public policies into routine collaborative practices.