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PRODUCTION OF CARE IN MENTAL HEALTH: TERRITORIAL PRACTICES IN THE PSYCHOSOCIAL NETWORK

Abstract

This is a qualitative study that analyzed the practices of territorial care in mental health developed by nurses, community health workers and users of the psychosocial care centers and of primary health care. We conducted interviews, focus groups and free observation with 60 participants from the city of Fortaleza, state of Ceará, Brazil, in 2017. The data analysis was based on hermeneutics-dialectics in the face of a critical and reflective interpretive exercise. The results revealed that the territorialization process is developed by the multidisciplinary team from the Health of the Family Strategy, without the participation of the professional of the psychosocial care center. Even though they may sometimes develop community practices, they still privilege actions within the service itself and those focusing on the medicalization of mental suffering, without taking into consideration the singularities of the subjects, and with no interaction with the primary health care services. The community health workers, if trained, are potentially strategic actors to work on the interface between mental health and primary health care. In fact, the mental health outlook urges for the transformation of a model that privileges the reflection of new actions into multiple dimensions, with an emphasis on the connection of the services and the training of the workers that act in this context.

health care; primary health care; mental health; mental health services; community health workers

Fundação Oswaldo Cruz, Escola Politécnica de Saúde Joaquim Venâncio Avenida Brasil, 4.365, 21040-360 Rio de Janeiro, RJ Brasil, Tel.: (55 21) 3865-9850/9853, Fax: (55 21) 2560-8279 - Rio de Janeiro - RJ - Brazil
E-mail: revtes@fiocruz.br