Mental health Nursing interventions in Primary Health Care: scoping review

This is a scoping review, carried out in the following databases: VHL, PUBMED, CINAHL, EMBASE, SCOPUS, Web of Science, PsycINFo, EBSCO, BMC Psychology, BMC Nursing, BMC Psychiatry, PEPsic, Google Scholar, CAPES Theses and Dissertations Database. Data were analyzed and synthesized in a narrative form.

Results

A total of 60 studies were included in the review. Most studies were published in Brazilian journals. The mapping of mental health nurses’ interventions in Primary Health Care suggests that the most common actions are assisting the users and referring them to the medical doctor or to specialized mental health services.

Conclusion

There is a wide scope of interventions within the competence of Primary Health Care nurses, but the lack of technical-scientific knowledge restricts care to the biomedical model.

Nurses’s hole; Mental health assistance; Primary health care; Mental health; Psychiatric nursing

Category	Variable	n(%)
Study participants	Nurses Nurses and family health teams Nurses and interdisciplinary teams * Review and reflection studies	29(48.0) 10(17.0) 6(10.0) 15(25.0)
Study design	Qualitative Quantitative Integrative Review Literature Review Mixed Others ( Experimental Study, Quasi-experimental Study, Systematic Review, Cartography, Randomized Clinical Trial)	33(55.0) 10(17.0) 06(10.0) 3(5.0) 2(3.0) 6(10.0)
Interventions in Mental Health of nurses working in PHC	Welcoming Referral Home consultations Matrix support Health education Nursing consultation Family support Complementary integrative practices Patient safety Mental health nursing consultation Continuing education	31(24.0) 26(20.0) 17(13.0) 14(11.0) 9(7.0) 9(7.0) 7(7.0) 8(6.0) 2(2.0) 2(2.0) 4(4.0)

Mental Health Interventions
Intervention	Sub-intervention
Nursing consultation^{(11,27,46,53,57,65,67,75)}	Substance use screening using ASSIST ⁽⁷⁴⁾ CMD Screening^(24,64) Family Planning⁽⁶⁷⁾ Guidelines^(24,37,67) Brief Interventions⁽⁷⁴⁾
Welcoming ^{(6,17,21-24,27–29,31–38,55)}	Qualified Listening^(6,22,23,40) Bonding^{(31,35,37–39)} Counseling⁽⁴⁹⁾ Triage⁽⁵⁵⁾
Referral^{(19,20-22,25,28,31,35,36,41,42,44–50)}	Referral to the specialized service (CAPS)^{(21,22,25,28,31,36,41,42,44,45,47,49,50)} Referral to another health professional (physician)^{(19,20,22,28,42,48)}
Home consultations^(55,58)	Home Visits^{(17,20,27,35,37,40,44,46,47,53,54,56–58)} Follow-up⁽¹⁷⁾
Matrix support^{(21,22,41,51,54,59–63)}	Matrix Care ^(41,54) Singular Therapeutic Project^(11,41) Team meeting^(21,22,41) Case Discussion^(21,22,41)
Health education^{(19,20,33,47,65,66)}	Health Education Groups⁽⁶⁵⁾ Educational Activities^(19,20) Therapeutic Workshops⁽⁶⁶⁾ Lectures⁽²⁴⁾
Family support^{(1,6,24,33,47,58,68)}	Family Care ^(1,47,58) Guidelines for family members ^(24,68) Health Education Groups⁽³³⁾ Home Visits⁽⁵⁸⁾
Complementary integrative practices ^{(6,18,26,44,57,69,71)}	Integrative Community Therapy^{(18,26,44,57,71)} Alternative and Complementary Therapies⁽⁶⁾
Continuing education^(31,72-74)	Training in Mental Health^(72,73)
Patient safety^(24,68)	Guidelines on the rational use of psychotropic drugs Guidelines for family members^(24,68) Guidelines for family members^(24,68)
Mental health nursing consultation^(61,75)	Therapeutic Relationship^(13,64) Orientation^(24,37,67)

Intervention
Welcoming^{(12,15,17,19-21,22-41)}	It is considered the main care technology in PHC*. It is a competence of nurses, performed by the nursing team as a change of direction of the care model, associated with the SUS† Humanization Policy. It is defined as the moment when the professional and the health user meet through qualified listening; it is conducive to the establishment of a bond and increases the system’s ability to solve mental health demands.
Referral^{(6,11,12,20,21,27,29,32,36,37,42-51)}	In the conception of the Health Care Network, referrals to specialized mental health services are necessary to provide comprehensive interventions. In the same logic, we conceptualize referrals as referring patients who need interventions and who are under the competence and responsibility of other team members to other health professionals. In both situations, nurses must use exhaust the possibilities of interventions within their competence to give quality referrals that respect the longitudinality and comprehensiveness of care.
Home consultations ^{(14,17,20,27,28,31,36,38,41,45,47,48,53-59)}	Home care aims to improve the bond with the user/family, get to know the environment and the family/social relationships of the user, increase access to health and intervene in the health-disease process.
Matrix support ^{(13,14,16,21,22,42,53,55,60-64)}	Matrix support is an organizational arrangement to increase the ability to solve health problems and expand the mental health clinic of the local team, with the inclusion of specialists from the NASF‖ or CAPS (interdisciplinary teams).
Health education^{(1,20,31,34,36,48,65-67)}	Health education encompasses interventions that enable an organized social response to mental health problems and needs, through educational activities involving teams and users/family/community and carried out in different social facilities.
Nursing consultation ^{(11,13,14,27,28,47,54,57, 68)}	It is an exclusive competence of the nurse, regulated in the Professional Practice Law No. 7.498/1986 and guaranteed by COFEN** Resolution no. 358/2009. In PHC,* it is a Health Care practice derived from the Systematization of Nursing Care, which is based in the Theory of Human Needs and the Nursing Process of Wanda Horta, divided into 5 stages: history, nursing diagnosis, care plan, nursing prescription and nursing evolution.
Family support^{(1,6,25,34,48,59,69)}	Mapped interventions related to health promotion for families of people with mental disorders and/or substance users in the territory, represented by care for the demands of family members through tools capable of evaluating and intervening in situations of vulnerability.
Complementary integrative practices^{(1,6,18,45,6,7,69-71)}	Mapped interventions related to health promotion for families of people with mental disorders and/or substance users in the territory, represented by care for the demands of family members through tools capable of evaluating and intervening in situations of vulnerability.
Continuing educatio^n(32,72-74)	Continuing education aims to create spaces for the construction of knowledge that can change health care practices through training in mental health.
Patient safet^y(24,68)	Set of interventions aimed at promoting the rational use of psychotropic drugs, through the evaluation of prescriptions of pharmaceuticals, balancing the benefits and harms along with the prescribers.
Mental health nursing consultation ^(61,75)	Intervention based on interpersonal relationships. According to the humanist conception of Peplau and Travelbe, it occurs through Therapeutic Communication and Person-Centered Approach.

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[1] Corresponding author Caroline Figueira Pereira E-mail: pereiracf@usp.br