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Building a process of mental health care network: challenges and potentialities of the Psychiatric Reform

This work aims to investigate how the mental health care network has been built in Santa Maria, State of Rio Grande do Sul, focusing on its articulation with the ideals of the Psychiatric Reform and the SUS. The methodology was the Systemic and Integral Action Research. The research subjects were managers and workers of the municipal Health Department. Data collection was carried out through participant observation in Mental Health Commission meetings, as well as in interviews with informants. Data points out that the reference and counter-reference system is little effective and that the working processes are fragmented (causing treatment discontinuity, lack of professional responsabilization etc). Strategies towards the construction and articulation of the network, agreed among health managers and workers, involve the implantation of substitute services, implementation of a Mental Heath Care Commission and the process of training capabilities regarding mental heath care towards basic health care. Yet, we found a series of strategies grounded on the routine of the working processes, determining an informal network - not foreseen by health macro-politics. Hereby, we problematize some principles that underline the network organization concerning SUS and the Psychiatric Reform, as well as the ambiguous effects of the way the network construction and articulation are accomplished.

Network; SUS; Psychiatric Reform; mental health


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