TELEPSYCHIATRY IN BRAZIL: EXPANSION OF ACCESS TO MENTAL HEALTH CARE, ETHICAL CHALLENGES, AND IMPLICATIONS FOR QUALITY OF CARE

Abstract

Telepsychiatry in Brazil has become an important strategy to expand access to mental health services, especially after the national regulation of telehealth. This study aimed to analyze the expansion of psychological and psychiatric telecare between 2021 and 2025, discussing its impacts on equity, ethical and legal challenges, and quality of care. This is a systematic literature review conducted according to PRISMA guidelines, with searches performed in the SciELO, LILACS, PubMed, and BVS databases using descriptors related to telepsychiatry, mental health, professional ethics, and data protection. The results were organized into three analytical axes. The first highlighted the expansion of access to services, the reduction of geographic barriers, and improved continuity of care, especially in regions with a shortage of specialists. The second emphasized ethical and legal challenges related to confidentiality, protection of sensitive data, and professional responsibility. The third showed that the quality of care and the therapeutic bond can be maintained in the virtual environment when there is adequate technical preparation, clear definition of the therapeutic setting, and integration with in-person services. Telepsychiatry can therefore strengthen public mental health policies.