4 should present detailed updated information on the status of the said criminal action; in particular, on any progress in decisions concerning the said remedies. * * * 13. Regarding the obligation to continue implementing an education and training program for all those who provide mental health care; particularly on the principles that should govern the treatment of individuals suffering from mental disabilities in accordance with the relevant international standards and those established in the judgment (eighth operative paragraph of the judgment), the State reiterated information presented in previous briefs and submitted a chronological account of the measures it has taken since 2002 to train mental health professionals. In this regard, among other measures, it referred again to the National Policy of Permanent Health Care Education (PNEPS), to the Universidad Abierta del Sistema Único de Salud [Open University of the Single Health Care System] and to the Emergency Plan to Expand Access to Prevention of and Attention to problems arising from Alcohol and other Drugs. It added that the Ministry of Health is seeking to stimulate the measures it considers priority by means of norms and financial resources, and is working to expand the offer of mental health care training under the Ministry’s permanent education policy. Accordingly, the State had prepared a list of the universities that offer courses in the area of mental health care and that could offer distance courses; defined the content required to train professionals who work in the area of public health; provided technical support and incentives for the authorities of the federated states and the municipalities to prioritize training in mental health in their respective permanent education plans, and proceeded to analyze the offer and the need to expand medical residency programs, selecting psychiatry as a priority area. Furthermore, it indicated that, during 2009, it had implemented the Pro Residencia program and launched an invitation to support medical residency programs, above all in the North, Northeast and West Central regions of the country; it had defined and delivered to the federated states the financial resources for the PNEPS, regulated and supported other courses of Multi-professional Residency in the health sector (RMS) and created the National Program of RMS Grants, among other actions. 14. Regarding “the length, frequency, and number of participants in the said activities,” the State indicated that, in general, “the training courses and events are offered on an annual basis and their minimum length responds to the method employed.” The length of specialization courses is 360 hours; advanced training courses, 120 hours, and refresher courses, 40 hours. In addition, it advised that “20 specialization courses on mental health care had been held for 838 professionals, corresponding to an investment of R$15,320,379.47 (fifteen million three hundred and twenty thousand three hundred and seventy-nine reales and forty-seven cents).” It also indicated that, from 2002 to 2008, the permanent training program related to reform of the area of psychiatry trained 9,112 professionals from different Brazilian states. Regarding the obligatory nature of training, it underscored that decentralization is one of the guiding principles of the Single Health Care System (SUS); on this basis, the states and municipalities have autonomy to define measures relating to health care, in line with their needs and particularities, and this includes the implementation of training courses for professionals who are part of the psycho-social attention network. Based on the foregoing, the State asked the Court to declare that the obligation to continue implementing education and training programs for professionals working in the area of mental health care had been fulfilled.

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