Objective: To analyze forms of articulation that the Centers for Psychosocial Care (CAPS) established with the Primary Health Care Services. Methods: A descriptive, qualitative study conducted using document review of 23 Therapeutic Projects of the CAPS type I and II, of 23 cities in the southern region of Brazil (PR, SC and RS). Results: It was observed that the structure of articulation occurs basically through the supervision and training of teams, and a reference and counter-reference system, often masked under the logic of the referrals. However, these actions are more suggestive, referred to in documents as objectives, than they are properly translated into actions and concrete operational logic of those in daily practice services. Conclusion: In fact, attention to the complexity of the demand for mental health is dependent on a gradual construction of joint responsibility guided by the various services that comprise the network of care. Keywords: Health care reform; Mental health services; Primary health care; Public policies; Unified Health System RESUMO Objetivo: Analisar as formas de articulação que os Centros de Atenção Psicossocial (CAPS) estabelecem com os Serviços de Atenção Básica de Saúde. Métodos: Estudo descritivo de abordagem qualitativa realizado por meio de análise documental de 23 Projetos Terapêuticos dos CAPS tipo I e II de 23 cidades da Região Sul do Brasil (PR, SC e RS). Resultados: Pôde-se observar que esta articulação estrutura-se basicamente na supervisão e capacitação das equipes e em um sistema de referência e contrarreferência, muitas vezes, mascarados sob a lógica dos encaminhamentos. No entanto, estas ações encontram-se mais sugestivas, referidas nos documentos como objetivos, do que propriamente traduzidas em ações como lógica de operacionalização concreta destas, na prática cotidiana dos serviços. Conclusão: De fato, a atenção à complexidade da demanda em saúde mental é dependente de uma construção gradativa de articulações orientadas pela corresponsabilização dos diferentes serviços que compõem a rede de atenção. Descritores: Reforma dos serviços de saúde; Serviços de saúde mental; Atenção primária à saúde; Políticas públicas; Sistema Único de Saúde RESUMEN Objetivo: Analizar las formas de articulación que los Centros de Atención Psicosocial (CAPS) establecen con los Servicios de Atención Básica de Salud. Métodos: Estudio descriptivo de abordaje cualitativo realizado por medio de análisis documental de 23 Proyectos Terapéuticos de los CAPS tipo I y II de 23 ciudades de la Región Sur del Brasil (PR, SC y RS). Resultados: Se puede observar que esta articulación se estructura básicamente en la supervisión y capacitación de los equipos y en un sistema de referencia y contrarreferencia, muchas veces, enmascarados bajo la lógica de los encaminamientos. Entre tanto, estas acciones se encuentran más sugestivas, referidas en los documentos como objetivos, de lo que propiamente traducidas en acciones como lógica de operacionalización concreta de éstas, en la práctica cotidiana ...
The University of Sao Paulo School of Nursing (EEUSP) went through a period of transition from undergraduate syllabus between the years 2009 and 2010. This change was made to integrate basic and clinical cycles and to reduce fragmentation of the disciplines. The mental health nursing education was included in many modules including the primary care. This qualitative study aimed to identify how the service offered to people with mental illness was performed by 20 undergraduate students in the context of primary care and how they were prepared. Data collection was conducted through semi-structured interviews, in August 2012, in EEUSP After thematic analysis, we separated in categories: Teaching-learning process, Basic Health Unit and Mental health-illness process. The socially constructed conception of madness added to the problems related to academic training may result in lack of preparation in nursing mental health care.
This study aimed to know the meanings present in the discursive practices of the Centers for Psychosocial Care's professionals, produced by new ways to cope and relate to the subject in severe psychological crisis. This is a qualitative research, based on the theoretical perspective of social constructionism. It was analyzed 27 interviews of professionals from the identification of interpretative repertoires and construction of Association of Ideas Maps. Data were organized into themes: Difficulties of contention in service; Senses built around this practice; Professionals placements regarding that practice; Participation of the Military Police in the care of the crisis; Sense of responsibility of the nursing staff in caring for the crisis. It was demonstrated the need for discussion and construction of crisis care practices that are more collective and contract based on solid relationships that respect the uniqueness and subjectivity of the subject.
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