0281/2024 - Entre as ruas e a RAPS: Revisão integrativa sobre acesso das pessoas em situação de rua aos Serviços de Saúde Mental Between the streets and the RAPS: Integrative review on the access of homeless people to mental health services
Esta revisão integrativa sistematizou os fatores que influenciam o acesso da População em Situação de Rua (PSR) que faz uso prejudicial de álcool e outras drogas aos serviços de saúde mental na Rede de Atenção Psicossocial (RAPS) no Brasil, a partir da categorização dos fatores em “barreiras” e “facilitadores” de acesso. Selecionou-se 13 artigos correspondentes, com avaliação posterior de sua qualidade metodológica. Foram encontradas 19 barreiras e 22 facilitadores de acesso, observando uma convergência e complementaridade dos fatores identificados, sem dissensos entre autores. Embora existam barreiras e facilitadores específicos relacionados ao uso de substâncias, a maioria são vinculadas às condições e modos da vida da PSR, ou às formas dos serviços de lidar com a PSR. A discriminação, rigidez burocrática dos serviços, e a falta de integração intra e intersetorial foram identificadas como barreiras significativas. Por outro lado, os Consultórios na Rua e práticas como a redução de danos e o matriciamento emergiram como facilitadores notáveis, adaptando-se às necessidades dos usuários. Há necessidade de estudos futuros que se aprofundem em fatores específicos e nas relações entre estes fatores, e proponham estratégias factíveis para que as políticas e serviços de saúde consigam ofertar acesso equânime à PSR.
Palavras-chave:
Pessoas em situação de rua. Acesso aos Serviços de Saúde. Serviços de Saúde Mental. Transtornos Relacionados ao Uso de Substâncias Psicoativas.
Abstract:
This integrative review systematized the factors that influences access to mental health services for homeless people in harmful use of alcohol and other drugs in the Psychosocial Care Network (RAPS) in Brazil, by categorizing the factors into \"barriers\" and \"facilitators\" of access. Thirteen corresponding articles were ed, with subsequent assessment of their methodological quality. We identified 19 barriers and 22 facilitators of access, observing a convergence and complementarity of the factors identified, with no disagreements between authors. Although there are specific barriers and facilitators related to substance use, most are connected to the conditions and lifestyles of HP, or to the ways in which services deal with HP. Discrimination, bureaucratic rigidity of services, and a lack of intra- and intersectoral integration were identified as significant barriers. On the other hand, the \" Consultórios na Rua \'\' (Street Clinics) and practices such as harm reduction and matrix support emerged as notable facilitators, adapting to patients\' needs. There is a need for future studies that explore specific factors and the relationships between these factors, and propose feasible strategies for health policies and services to be able to offer equitable access to HP.
Keywords:
Homeless population. Health Services Accessibility. Mental Health Services. Substance-Related Disorders.
Between the streets and the RAPS: Integrative review on the access of homeless people to mental health services
Resumo (abstract):
This integrative review systematized the factors that influences access to mental health services for homeless people in harmful use of alcohol and other drugs in the Psychosocial Care Network (RAPS) in Brazil, by categorizing the factors into \"barriers\" and \"facilitators\" of access. Thirteen corresponding articles were ed, with subsequent assessment of their methodological quality. We identified 19 barriers and 22 facilitators of access, observing a convergence and complementarity of the factors identified, with no disagreements between authors. Although there are specific barriers and facilitators related to substance use, most are connected to the conditions and lifestyles of HP, or to the ways in which services deal with HP. Discrimination, bureaucratic rigidity of services, and a lack of intra- and intersectoral integration were identified as significant barriers. On the other hand, the \" Consultórios na Rua \'\' (Street Clinics) and practices such as harm reduction and matrix support emerged as notable facilitators, adapting to patients\' needs. There is a need for future studies that explore specific factors and the relationships between these factors, and propose feasible strategies for health policies and services to be able to offer equitable access to HP.
Palavras-chave (keywords):
Homeless population. Health Services Accessibility. Mental Health Services. Substance-Related Disorders.
Fraga, P. V. R, Araújo, M. C. A., Souza, A.A, Martins, A. L. J., Dantas, A. C. M. T. V., Marinho, R. A., Rodrigues, D. M., Paes-Sousa, R.. Entre as ruas e a RAPS: Revisão integrativa sobre acesso das pessoas em situação de rua aos Serviços de Saúde Mental. Cien Saude Colet [periódico na internet] (2024/jul). [Citado em 04/02/2025].
Está disponível em: http://cienciaesaudecoletiva.com.br/artigos/entre-as-ruas-e-a-raps-revisao-integrativa-sobre-acesso-das-pessoas-em-situacao-de-rua-aos-servicos-de-saude-mental/19329?id=19329
