Análise das ações de saúde mental na atenção básica: fragilidades e desafios

Abstract

The potential of Mental Health in Primary Care is defended in this work as a strategic issue for the consolidation of the Brazilian Psychiatric and Sanitary Reform. Considering that the process of the Brazilian Psychiatric Reform has prioritized de hospitalization through substitutive services as the strategic path to deinstitutionalization, the inclusion of mental health actions in primary care is fragile and needs to expand its actions. The general objective of the present work is to build a decision support system about prevailing profiles of several actions to support decision making in health management, contextualized with an analysis of mental health actions in basic care in Brazil. This work explores secondary data from the external evaluation base of the National Program for Improving Access and Quality in Primary Care with interviews of 29,778 family health and primary care teams. The analysis of the actions was systematized by the regions of the country. An index that generated ratings was constructed. The Decision Support System for Mental Health Actions in Primary Care has an algorithm called the "Partial Decision Tree" - PART. The presented tool can subsidize the decision making on actions of support matrix, institutional and permanent education. The scenario is that most health facilities do not perform a minimal scope of mental health records and actions. The most prevalent action profile is: they stated that they serve users in psychological distress, but lack actions aimed at users who abuse alcohol and other drugs and psychotropic drugs. With this, it highlights challenges for the expansion and consolidation of the Family Health Strategy and the Brazilian Sanitary and Psychiatric Reforms. Finally, there is no way to support the ideological, cultural, social and political-political struggle that advocates an assistance proposal if we can not provide evidence of its characteristics, development and results. The strengthening of the Brazilian Sanitary and Psychiatric Reforms certainly goes through the expansion of mental health actions in primary care.