A percepção e a prática dos profissionais da atenção básica sobre a saúde mental

Abstract

Mental health brings at its heart, innumerable stigmas and prejudices that can generate diverse barriers of access to the patients that need the resolutive attendance in the Basic Attention. The Family Health Strategy (ESF) proposes comprehensive care to people in its community, one of its assumptions being networking and intersectoriality. Regarding mental health care, the elucidation of the barriers to care is essential for the improvement of the services and access of patients to the treatment that encompasses their context of suffering, not just their diagnosis. Thus, the present research had as objective to know the perception and the practical reality in the action of the professionals of Basic Attention in the attention to Mental Health in the municipality of Itumbiara (GO). This is a cross-sectional study of the type of quantitative and qualitative survey carried out on professionals from the 20 ESF teams from the municipality of Itumbiara (GO) from September 2018 to January 2019. The questionnaire consisted of 20 questions on a scale of type Likert and 5 questions opened from a semi-structured roadmap. Likert scale questions were evaluated according to the frequency and distribution of proportions, and the score was transformed to a scale from zero to 100, zero related to the worst evaluation, and 100 to the best evaluation. The open questions were evaluated through the Bardin content analysis using the IRAMUTEQ software. Among the 174 professionals interviewed, 23.0% of the professionals agreed or fully agreed that they felt able to work with mental health in the FHT (n = 40), 37.9% that their team received mental health support (n = 82 ) and 37.5% that their team was able to organize care according to the unique demand of each patient (n = 64). Regarding difficulty in providing care to patients in Health, only 29.1% disagreed or totally disagreed (n = 48). The mean of the transformed score of all questions was 52.0 ± 13.7. The analyzed content of the open questions could be categorized into four classes according to the percentages of themes, being the words that present the most outstanding: people, health, mental, difficulty, patient and knowledge. It can be noticed from the speeches that the contact with patients and family members has been an important aggravating factor in the relationship between the FHT and the subject to which the care is intended, expressing the difficulty of the professionals not to feel able to deal with this demand. It can also be inferred that family health workers perceive themselves lacking matrix support to be carried out by the mental health reference unit of the municipality, realizing that their performance in the FHS is limited. Even though they present difficulties in their work, professionals are able to perceive their importance in the reality of the subjects with whom they relate and recognize the need for more preparation, more knowledge and new skills. In this way, it was possible to perceive the different degrees of difficulty both in the perception and in the practice of the workers, which allowed comparison with the sociological analysis of Giddens, evidencing that the routine is not created by the individual, but reproduced by him. Its criticality may determine that the structure remains or there may be a possibility of change.