Cartografia do cuidado em um território das Redes de Atenção Psicossocial
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Data
2018-02-22
Autores
Santana, Taís Fernanda Maimoni Contieri
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
Desde as últimas décadas, o sistema de saúde brasileiro tem passado por transformações essenciais, imprimindo um percurso caracterizado por enfrentamentos, desafios e avanços. Com a criação e implantação do SUS, mudanças significativas e necessárias vêm acontecendo, principalmente no campo da Saúde Mental. Dentre elas, a reversão do modelo manicomial para políticas de base territorial, como o cuidado integral nas Redes de Atenção Psicossocial (RAPS). Com o olhar voltado para essa questão, a presente pesquisa cartografou o cotidiano do cuidado em saúde mental dos profissionais atuantes numa Unidade Básica de Saúde articulada a um Centro de Atenção Psicossocial I (CAPSI). Para tanto, empregamos o método qualitativo e cartográfico. Utilizamos ferramentas, tais como a observação sistemática, diário de campo, fluxograma e entrevista audiogravável com onze profissionais que atuam nas unidades mencionadas acima, de um município do interior paulista. Três autores foram base referencial para análise: Emerson Merhy, autor que subsidiou a temática do cuidado; Benedetto Saraceno, autor que sustentou a discussão pertinente à Reabilitação Psicossocial e Eugênio Vilaça Mendes, autor que discutiu o trabalho em Redes, com enfoque na Rede de Atenção Psicossocial (RAPS). Como resultado, foi constatado que apesar do acolhimento e acesso ofertados, os encontros e narrativas no território das redes conectivas da RAPS revelaram a fragilidade dos profissionais entrevistados frente aos cuidados em saúde mental na Atenção Primária, visto a percepção deturpada de que o cuidado é hegemônico e medicalizante, tendo o CAPS I como seu ordenador na maioria das vezes. Foi detectada, em algumas situações, uma mobilidade dos trabalhadores na rede, circulando entre os equipamentos de saúde. Isso favoreceu as conexões e fluxos entre equipes na construção das linhas de cuidado, sendo possível sentir as nuances das práticas em rede, dos novos serviços sob essa lógica que podem ser denominados espaços de produção de sujeitos sociais, de produção de subjetividades. A partir da cartografia, percebemos que a atenção em saúde mental no território pesquisado requer políticas intersetoriais, integradas, ampliando possibilidades, oportunidades e redimensionando a noção de direito e cidadania, bem como considerando o usuário como integrante da elaboração de projetos terapêuticos, fortalecendo o trabalho multiprofissional e qualificando os profissionais para as ações dirigidas ao cuidado. Destarte, a articulação de profissionais no campo da saúde mental em rede deve promover a constituição de um conjunto vivo e concreto de referências capazes de acolher a pessoa em sofrimento, sendo que esta rede, no entanto, não deve limitar-se aos serviços especializados.
Since the last decades, the Brazilian health system has gone through essential changes, establishing a path characterized by confrontations, challenges, and improvements. With the creation and implementation of the Unified Health System (SUS), necessary and substantial changes have been happening, mainly in the area of mental health. Among them, the reversal of the asylum model for territorial basis policies, such as the full care in the Psychosocial Care Networks (RAPS). Focusing on this issue, this research charted the mental health care of professionals from a Health Center linked to a Center for Psychosocial Attention I (CAPS). For this purpose we used the cartographic and qualitative method. We used tools, such as systematic observation, a field diary, a flowchart and a recordable interview with eleven professionals who work in the above-mentioned health centers of an inner city in the State of São Paulo. Three authors supported the analysis: Emerson Merhy, who subsidized the care topic; Benedetto Saraceno, who supported the discussion about Psychosocial Rehabilitation and Eugênio Vilaça Mendes, who discussed the work in Networks, focusing on the Psychosocial Care Network (RAPS). As a result, it was stated that despite the offered access and reception, the encounters and narratives in the area of connective network from RAPS revealed the fragility of the interviewed professionals facing mental health care in the Primary Health Care, considering the distorted perception that care is hegemonic and medicalized, often using the CAPSI I as its authorizing officer. It was detected, in some cases, a mobility of the workers in the network, transiting between health equipment. This fact promoted the connections and flows between teams in the construction of care lines, making it possible to feel the nuances of network practices in new services under this logic, which can be called production spaces of social individuals, of production and subjectivity. From this cartography, we noticed that the attention to mental health in the studied area requires integrated intersectoral policies, widening possibilities, opportunities and resizing the idea of human rights and citizenship, as well as considering the user as a member in the elaboration of therapeutic projects, reinforcing the multi-professional work and qualifying professionals to care related actions. Therefore, the articulation of mental health network professionals should promote the formation of a real and solid group of references capable of receiving the individual in pain, however, this network, should not limit itself to specialized services.
Since the last decades, the Brazilian health system has gone through essential changes, establishing a path characterized by confrontations, challenges, and improvements. With the creation and implementation of the Unified Health System (SUS), necessary and substantial changes have been happening, mainly in the area of mental health. Among them, the reversal of the asylum model for territorial basis policies, such as the full care in the Psychosocial Care Networks (RAPS). Focusing on this issue, this research charted the mental health care of professionals from a Health Center linked to a Center for Psychosocial Attention I (CAPS). For this purpose we used the cartographic and qualitative method. We used tools, such as systematic observation, a field diary, a flowchart and a recordable interview with eleven professionals who work in the above-mentioned health centers of an inner city in the State of São Paulo. Three authors supported the analysis: Emerson Merhy, who subsidized the care topic; Benedetto Saraceno, who supported the discussion about Psychosocial Rehabilitation and Eugênio Vilaça Mendes, who discussed the work in Networks, focusing on the Psychosocial Care Network (RAPS). As a result, it was stated that despite the offered access and reception, the encounters and narratives in the area of connective network from RAPS revealed the fragility of the interviewed professionals facing mental health care in the Primary Health Care, considering the distorted perception that care is hegemonic and medicalized, often using the CAPSI I as its authorizing officer. It was detected, in some cases, a mobility of the workers in the network, transiting between health equipment. This fact promoted the connections and flows between teams in the construction of care lines, making it possible to feel the nuances of network practices in new services under this logic, which can be called production spaces of social individuals, of production and subjectivity. From this cartography, we noticed that the attention to mental health in the studied area requires integrated intersectoral policies, widening possibilities, opportunities and resizing the idea of human rights and citizenship, as well as considering the user as a member in the elaboration of therapeutic projects, reinforcing the multi-professional work and qualifying professionals to care related actions. Therefore, the articulation of mental health network professionals should promote the formation of a real and solid group of references capable of receiving the individual in pain, however, this network, should not limit itself to specialized services.
Descrição
Palavras-chave
atenção primária à saúde, cartografia, cuidado, rede de atenção psicossocial, saúde mental, enfermagem, primary health attention, cartography, care, nursing, center for psychosocial attention, mental health