Atenção à saúde mental na estratégia saúde da família: construção de uma tecnologia educativa como ferramenta de educação permanente

Abstract

High rates of mental illness have become a significant global public health issue, highlighting the need for the development of research in the field of mental health and technologies that enable professionals to provide better quality care to users suffering from mental health issues. In this context, Primary Health Care (PHC), as the gateway to the Unified Health System (UHS) and playing a crucial role in the management of SUS, becomes indispensable, as the need to adapt the work process developed by the PHC teams to meet mental health demands is imperative. Therefore, this study is an exploratory descriptive research with a qualitative approach that aimed to analyze the mental health care provided by the Family Health teams in the municipality of Parnamirim/RN, as well as to identify the technologies and work tools adopted by the teams to enable mental health actions, identify the problems, weaknesses, and potentials related to the mental health demand from the perspective of the PHC professional, and to develop, from the research, an educational technology aimed at contributing to the training process of PHC professionals. In accordance with the study's scope, work was conducted with health professionals who make up the Family Health Strategy teams across the seven territories of the municipality, totaling 20 individuals, including doctors, nurses, nursing technicians, and community health agents. Data collection was carried out through individual interviews with a semi-structured guide. The interview data were coded, summarized, systematized, and analyzed with a qualitative data analysis software, ATLAS.ti version 23, and Bardin's Thematic Analysis method was used for the analysis, resulting in five categories of analysis: 1) Mental Health Practices offered by the professionals of the Family Health Strategy (FHS): what is seen and what is done; 2) Reception as care technology in Mental Health in PHC: the real and the ideal; 3) "Us" in the Psychosocial Care Network (PCN): what is known and what is done; 4) Limits and possibilities of Mental Health Care in PHC; 5) Continuous Education as a potential for the qualification of Mental Health practices. The main result showed fragmented care concerning mental health, with poor coordination between PHC and the services that make up the PCN, making comprehensive care unfeasible. The practices of “mental health care” prevail based on an essentially biomedical model and with strong medicalization. Regarding the limitations for mental health care in PHC, the lack of training, insufficient resources, problems in the coordination of the care network, the fragility of the psychosocial care network without well-defined flows, difficulty accessing the network, lack of communication, workload, and the absence of matrix support stand out. However, the professionals highlighted the potential of PHC, as they see it as a conducive space for the construction of bonds, longitudinally, and resolution. The suggestions point to the implementation of continuous education activities and the development of strategic tools that help professionals more safely handle mental health demands. From the findings of the study, an educational technology in the form of a booklet (mental health booklet: welcoming psychological suffering in PHC) was developed as a technical product. The material created, aimed at PHC health professionals, and containing information to be used in professional practices as a qualification instrument, has the potential to impact both the health services of the municipality where the study occurred and other PHC services that show similarity with this research, in order to improve assistance to users suffering psychological health issues and to promote comprehensive care.