0063/2015 - Práticas assistenciais em saúde mental na atenção primária à saúde: análise a partir de experiências desenvolvidas em Florianópolis Mental health care practices in primary health care: an analysis from experiences in Florianópolis
• Charles Tesser - Tesser, Charles - UFSC, Professor Programa de Pós Graduação Saúde Coletiva - <charles.tesser@ufsc.br>
Área Temática:
Saúde Mental
Resumo:
Analisou-se um conjunto de práticas assistenciais em saúde mental na atenção primária à saúde (APS) de Florianópolis, tendo como base a diferenciação proposta por Abílio Costa-Rosa entre os modos asilar-psiquiátrico e de atenção psicossocial. Os métodos envolveram: a) contextualização do campo empírico com análise documental e entrevistas com gestores; b) mapeamento de intervenções em entrevistas com profissionais de nove equipes de ESF sorteadas; c) aprofundamento do entendimento destas ações em observações e entrevistas com profissionais e em 20 estudos de caso, que foram sistematizados conforme o fluxograma proposto por Merhy, por meio de entrevistas com usuários e análise dos prontuários. Identificou-se que ações voltadas ao acesso e monitoramento dos casos envolviam toda a equipe e que o acompanhamento era centralmente médico e farmacológico. Ações estruturadas a partir da palavra, do contexto sociocomunitário e do corpo também estiveram presentes e mostraram potencial para operar em uma perspectiva de valorização da autonomia e singularidade, estando, muitas vezes, subutilizadas pela falta de incorporação da abordagem psicossocial. Aponta-se a necessidade de avançar no modelo de atenção, ainda muito afeito à psiquiatria comunitária ou preventiva, e a pertinência de, na aproximação entre atenção psicossocial e APS, valorizar-se a relação entre corporeidade e subjetividade.
A set of mental health care practices in primary health care (PHC) in Florianópolis were analyzed, departing from the differentiation proposed by Abílio Costa-Rosa between the asylum model and the psychosocial care model. Methods included: a) documentary analysis and interviews with managers; b) interviews with health professionals from nine randomly chosen Family Health Strategy teams; c) a deeper analysis of these interventions through observations, interviews with professionals and through 20 case studies constructed from interviews with service users and analysis of medical records, which were systematized according to the flowchart proposed by Merhy. The study identified that activities that focused on access and monitoring of cases involved the whole team, but that the follow-up is medically and pharmacologically-centered. Actions that dealt with the word, the social context and the body were also present and showed potential to operate in a perspective that values autonomy and singularity, but were often underutilized as they lacked the incorporation of the psychosocial approach. The study points to the need to advance the care model, still very accustomed to the notions of community or preventive psychiatry, and identifies the relevance of bringing psychosocial care and PHC together, as a form of increasing the interface between corporeality and subjectivity.
Keywords:
Primary Health Care
Mental Health
Care Practices
Care Models
Amplified Clinic
Mental health care practices in primary health care: an analysis from experiences in Florianópolis
Resumo (abstract):
A set of mental health care practices in primary health care (PHC) in Florianópolis were analyzed, departing from the differentiation proposed by Abílio Costa-Rosa between the asylum model and the psychosocial care model. Methods included: a) documentary analysis and interviews with managers; b) interviews with health professionals from nine randomly chosen Family Health Strategy teams; c) a deeper analysis of these interventions through observations, interviews with professionals and through 20 case studies constructed from interviews with service users and analysis of medical records, which were systematized according to the flowchart proposed by Merhy. The study identified that activities that focused on access and monitoring of cases involved the whole team, but that the follow-up is medically and pharmacologically-centered. Actions that dealt with the word, the social context and the body were also present and showed potential to operate in a perspective that values autonomy and singularity, but were often underutilized as they lacked the incorporation of the psychosocial approach. The study points to the need to advance the care model, still very accustomed to the notions of community or preventive psychiatry, and identifies the relevance of bringing psychosocial care and PHC together, as a form of increasing the interface between corporeality and subjectivity.
Palavras-chave (keywords):
Primary Health Care
Mental Health
Care Practices
Care Models
Amplified Clinic
Frosi, Raquel, Tesser, Charles . Práticas assistenciais em saúde mental na atenção primária à saúde: análise a partir de experiências desenvolvidas em Florianópolis. Cien Saude Colet [periódico na internet] (2015/Mai). [Citado em 17/09/2024].
Está disponível em: http://cienciaesaudecoletiva.com.br/artigos/praticas-assistenciais-em-saude-mental-na-atencao-primaria-a-saude-analise-a-partir-de-experiencias-desenvolvidas-em-florianopolis/15129?id=15129
