Realising the future: Health challenges and achievements in Brazil

In the present paper, we take a critical public health perspective that accounts for social determinants of health and health inequalities to explore the challenges of healthcare — including mental healthcare — in Brazil. Brazil, which has been described as a country of continental dimensions, a country of contrasts, and the country of the future, was built on principles of exploitation of the land and of its people, and has faced many social, economic, and political challenges throughout its history. The creation of Brazil's Unified Health System (Sistema Único de Saúde — SUS), providing universal healthcare free of charge at point of use, attests to the country's resilience. Despite many advances, several issues remain in the promotion, prevention, and care for physical and mental health problems. Particularly for mental health, the recent increased demand for services following the Covid-19 pandemic has exposed the system's vulnerability in terms of coverage and reach, with underserved groups including youths, females, LGBTQIA+, non-white, and low-income individuals. By taking advantage of the SUS installed infrastructure and strengthening the primary care model on which the system is based, the SUS can become the blueprint to consolidate and expand mental healthcare in Brazil.