Inclusão das ações de saúde mental na atenção básica: possibilidades e desafios

Abstract

The Brazilian Psychiatric Reform movement marked the beginning of a long process of transformations in mental health care, which, in addition to deconstructing the asylum apparatus, provides for the creation of services inserted in the territory and articulated in a network. In this new scenario, the important role of the Family Health Strategy stands out as a powerful resource of the Psychosocial Care Network, since most of these services are located in regions of great social vulnerability, in addition, they present a significant number of people with disorders mental and who use psychoactive substances. This study aims to understand the team's perceptions of a Family Health Strategy about the Mental Health actions carried out in the territory. This is a qualitative exploratory research that was carried out in a Family Health Strategy in the municipality of Uruguaiana. Health professionals working in the service participated in the research. The data were collected through a semi-structured interview. From the data were collected through a semi-structured interview. Based on the data collected, thematic categories were divided into five categories: strategies used in mental health care in primary care, the need for permanent education about mental health care, stigmatized conceptions of the population and the team about health mental, centralization of mental health care in Psychosocial Care Centers and the lack of articulation of the network and Mental health in Primary Care: paths towards decentralized care. The present study can contribute to the reflection on the comprehensiveness and expansion of mental health care in the municipality. In view of the weaknesses to consolidate this articulation proposal pointed out in this study, it is considered relevant to carry out new studies focusing on different aspects of this theme in the municipality. exploratory and descriptive character, retrospective with a quantitative approach, developed in the Family Health Strategies (FHS) from August to October 2016. The study population consisted of medical records of pregnant women registered in the year 2013 in a municipality on the western border from RS, based on the latest sense provided by the Live Birth Information System (SINASC). According to the information contained in the medical records, the pregnant women attended were aged between 14 and 37 years of age and between three and eleven years of study. About 39% of pregnant women were primiparous, 35% had two pregnancies, 13% four pregnancies, 12% with three pregnancies and 1% five pregnancies. Regarding the delivery outcome, it was observed that 41% of pregnant women underwent cesarean delivery, 19% normal delivery and 40% of the medical records analyzed had no information on outcomes in relation to delivery. Regarding the number of prenatal consultations, 54.05% of pregnant women had a minimum of 6 or more consultations, reaching the recommended number. Pregnant women who had one to three consultations were 31%, and 14% had 4 to 5 prenatal consultations, data that indicate the possibility of increased risk for the outcome of pregnancy. Although gaps in prenatal care are identified in the units studied, there is a strong implication of health management in order to organize assistance to pregnant women within the scope of municipal primary care.