Análise dos determinantes sociais da saúde a partir das falas de familiares e usuários do CAPS

Abstract

Introduction: Mental health is a term used to describe the level of cognitive or emotional quality of life of a person, and the family member becomes an active agent in the treatment and provision of care for the person with mental disorder. Objective: To analyze the layers of Social Determinants of Health (SDH) based on the statements of family members and CAPS users. Method: This is a research with a descriptive, exploratory qualitative approach. Data collection was performed at CAPS II Chiquita Bacana, located in the city of Santa Cruz-RN, located in the region of Trairi. The study included all individuals who came to the CAPS for assistance during the collection period, accompanied by a person he considered as a family. A semi-structured interview was used, applied at the same time with both individuals, with questions directed to the family and the SDH. The findings that emerged from the participants' statements during the interviews were analyzed and discussed in the light of the Social Determinants of Health model proposed by Dahlgren and Whitehead (NCSDH, 2008), in addition to other appropriate literature in the field of public health. Results and discussion: The users participating in this study were between 18 and 58 years old, being three women and nine men. Among them, six were single, three were in a stable relationship, one was a widower, one was married and the other was divorced. The family members participating in the research were between 18 and 59 years old, one was male. Regarding marital status, four family members were married, five in a stable relationship, two divorced, and one single. As for education, one was illiterate, one did not remember how many years he studied, two finished elementary school, five have incomplete elementary education and one has incomplete higher education. Regarding religion, four were Protestant and eight were Catholic. The practice of physical exercise, access to the media and a comprehensive social network function as a source of support, stimulate the various social relationships and act as a protective factor. However, what is observed in this work is a deficiency of users in carrying them out, which ends up contributing to the isolation and triggering of other diseases. CAPS was mentioned as a space that allows these activities to be carried out. Other social spaces were also highlighted by the interviewees as a source of support and stimulate the various relationships, and these are permeated by strong bonds, in which care is also transferred to the actorsinvolved. However, in the survey, many reported preferring to stay at home, being a predisposed factor for isolation and exclusion. The family was considered an important social and affective support, having a relevant role in monitoring the subject in psychological distress, acting as the main source of material assistance, direct assistance to basic needs, and necessary for mental health care. Final considerations: It is considered that there is a need for practical actions that can reduce the existing gaps, between users and family members, that cause distance between health care services, as recommended by the Psychiatric Reform, with a view to thinking about advances in Collective Health with the integrality of the individual, his freedom and autonomy.