O cuidado ao sofrimento psíquico nos territórios: a saúde mental (re)vista pela Atenção Básica
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Data
2019-09-02
Autores
Garcia, Cristhiane Comitre
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Universidade Estadual Paulista (Unesp)
Resumo
O objeto da presente pesquisa foram as práticas de cuidado realizadas na Atenção Básica que promovem e/ou cuidam da saúde mental. A pesquisa teve como objetivo mapear e analisar as modalidades de cuidado, atenção e promoção em saúde mental disponibilizados pela Atenção Básica em um município de até 20.000 habitantes, que não contasse com equipamentos especializados de Atenção Psicossocial. A pesquisadora é trabalhadora na Atenção Básica de um pequeno município e, provocada pelo incômodo de perceber que a promoção da saúde mental vem sendo colocada como objeto, prioritariamente, de especialistas (psiquiatras e psicólogos), buscou investigar quais ações de cuidado integral e de atenção psicossocial são realizadas, cotidianamente, pelos não-especialistas em saúde mental. Eram questões disparadoras à pesquisa: Os trabalhadores são capazes de identificar a dimensão subjetiva dos usuários com os quais lidam? Reconhecem que, em seu território, grande parte das pessoas com sofrimento psíquico já vem sendo, efetivamente, acompanhada por eles? De que forma integram os cuidados da saúde mental aos cuidados da saúde física? Este estudo está articulado ao referencial teórico-metodológico da pesquisa qualitativa e à abordagem cartográfica e assume a interferência como um modo de estar em campo, valorizando a construção que se dá em conjunto com os participantes. Em resposta às questões iniciais desta pesquisa observa-se que a inclusão do cuidado e da promoção de saúde mental na Estratégia de Saúde da Família como prática reconhecida ainda é uma situação complexa a ser superada, mas fica evidente que as ações promovidas pela Atenção Básica voltadas ao cuidado da saúde mental estão permeando tudo que as equipes fazem, o tempo todo, ainda que não sejam, claramente, assim nomeadas. Para a produção de uma nova realidade psicossocial, é preciso fortalecer a Atenção Básica para que seus trabalhadores consigam reconhecer seus saberes e sua potência em lidar com as subjetividades.
The mental health practices performed in the Primary Care were the object of this research, as it aimed at mapping and analyzing the modalities of care, attention and promotion on mental health provided by Primary Care in a municipality of up to 20,000 inhabitants, not having specialized Psychosocial Care equipment. The researcher works on Primary Care in a small municipality. Being disturbed on realizing that the fostering of mental health was addressed first and foremost as object of specialists (psychiatrists and psychologists), she investigated which integral care actions and psychosocial care are performed on a daily basis by non-mental health specialists. Some triggering questions for research arose: Are workers in the area able to identify the subjective dimension of the users they deal with? Are they aware that in their territory most people with psychic distress have been attended by them? How do they merge mental health care with physical care? This study is articulated with the theoretical-methodological reference frame of qualitative research as well as with cartographic approach and assumes interference as a way of being in the field, valuing the construction that takes place together with the participants. It was observed when replying to the initial questions of this research that the inclusion of mental health care and fostering in the Family Health Strategy a recognized practice, is still a complex situation to be overcome. Nevertheless, it has become clear that the actions fomented by Primary Care focusing on mental health care are permeating everything the teams do all the time, even though not having been clearly named that way. For the production of a new psychosocial reality, it is necessary to strengthen Primary Care in order that the workers may recognize their knowledge and their power in dealing with subjectivities.
The mental health practices performed in the Primary Care were the object of this research, as it aimed at mapping and analyzing the modalities of care, attention and promotion on mental health provided by Primary Care in a municipality of up to 20,000 inhabitants, not having specialized Psychosocial Care equipment. The researcher works on Primary Care in a small municipality. Being disturbed on realizing that the fostering of mental health was addressed first and foremost as object of specialists (psychiatrists and psychologists), she investigated which integral care actions and psychosocial care are performed on a daily basis by non-mental health specialists. Some triggering questions for research arose: Are workers in the area able to identify the subjective dimension of the users they deal with? Are they aware that in their territory most people with psychic distress have been attended by them? How do they merge mental health care with physical care? This study is articulated with the theoretical-methodological reference frame of qualitative research as well as with cartographic approach and assumes interference as a way of being in the field, valuing the construction that takes place together with the participants. It was observed when replying to the initial questions of this research that the inclusion of mental health care and fostering in the Family Health Strategy a recognized practice, is still a complex situation to be overcome. Nevertheless, it has become clear that the actions fomented by Primary Care focusing on mental health care are permeating everything the teams do all the time, even though not having been clearly named that way. For the production of a new psychosocial reality, it is necessary to strengthen Primary Care in order that the workers may recognize their knowledge and their power in dealing with subjectivities.
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Palavras-chave
Saúde Mental, Atenção Psicossocial, Atenção Básica, Cuidado, Integralidade