Frosi Raquel Valiente, Tesser Charles Dalcanale
Departamento de Saúde Pública, Centro de Ciências da Saúde, Universidade Federal de Santa Catarina, Florianópolis, SC, Brasil,
Cien Saude Colet. 2015 Oct;20(10):3151-61. doi: 10.1590/1413-812320152010.10292014.
This article analyzes mental health care practices in primary health care (PHC) in the city of Florianópolis, which were based on proposals by Abilio Costa-Rosa regarding the asylum-psychiatric and psychosocial modes of care. The methods involved the following: a) the contextualization of the empirical field with documental analysis and interviews with managers; b) mapping interventions through interviews with professionals from nine selected Family Health Teams (ESF); c) deepening the understanding about these actions through observations and interviews with professionals and 20 case studies, which were systematized in accordance with the flowchart proposed by Merhy through interviews with service users and analysis of records. It was identified that the actions aimed at access and monitoring of the cases involved the whole team, and that medical and pharmacological treatment was centrally administered. Interventions based on words, socio-communitarian interventions and interventions based on the body were also present, and they showed the potential to operate from a perspective of valuing autonomy and singularity, aspects which are often underused when psycho-social approaches are absent. The need to improve care models and to bring together psychosocial care and PHC is suggested.
本文分析了弗洛里亚诺波利斯市初级卫生保健（PHC）中的精神卫生保健实践，这些实践基于阿比利奥·科斯塔 - 罗萨关于庇护 - 精神病学和社会心理护理模式的提议。方法如下：a）通过文献分析和与管理人员访谈对实证领域进行背景化；b）通过与九个选定的家庭健康团队（ESF）的专业人员访谈来绘制干预措施；c）通过观察以及与专业人员访谈和20个案例研究来加深对这些行动的理解，这些案例研究根据梅尔希提出的流程图，通过与服务使用者访谈和记录分析进行系统化整理。研究发现，旨在病例接入和监测的行动涉及整个团队，并且医疗和药物治疗由中心管理。基于言语的干预、社会社区干预和基于身体的干预也存在，它们显示出从重视自主性和独特性的角度开展工作的潜力，而在缺乏社会心理方法时，这些方面往往未得到充分利用。建议改进护理模式，并将社会心理护理与初级卫生保健结合起来。
