Access, equity and social cohesion: evaluation of intersectoral strategies for people experiencing homelessness

Abstract

Objective To understand and evaluate the work of intersectoral assistance on the insertion and the flow of people in situation of street with severe mental illness in public services of Mental Health. Method A case study developed from ten visits to a night shelter between March and April 2012. For data collection, the participant observation and semi-structured interviews were carried out with four sheltered individuals, as well as non-directive group interviews with five technicians of the social-assistance services. Results Were analyzed using Content Analysis and developing a Logic Model validated with the professionals involved. Conclusion The social assistance services are the main entry of this clientele in the public network of assistance services, and the Mental Health services have difficulty in responding to the specificities of the same clientele and in establishing intersectoral work.

Tool and ideological knowledge in Street Outreach Office working process

“…Drawn from the discourse of the CRT professionals, the emphases were on the aspects related to the resistance www.ee.usp.br/reeusp Tool and ideological knowledge in Street Outreach Office working process showed by Health Care Units (HCU) professionals in providing assistance and receiving the PSS, which was similar to the results of a study conducted in the countryside of the state of São Paulo: the authors observed that PHC professionals collectively raised questions that thwart the effective services provided to the PSS, practically excluding this possibility (13) . As an organizational barrier, the current format of health services was pointed out.…”

Atenção à saúde de pessoas em situação de rua: estudo comparado de unidades móveis em Portugal, Estados Unidos e Brasil

“…The prevalence of mental disorders and alcohol abuse and other drugs use adds to PIH breaking with their social networks and protective groups, increasing their vulnerability 6 . PIH are by the thousands in Brazil, the United States and Portugal [7][8][9] , where problems of access and continuity of health care are identified due to the inadequacy of services to the particularities of this group 3,10,11 and the stigma they suffer, including from workers 12 . Faced with these challenges, some countries have adopted outreach and roaming strategies to overcome limitations of spontaneous demand for this group 13 .…”

O Consultório na Rua e a atenção básica à população em situação de rua

“…A lógica especialmente excludente que atinge pessoas com TMG nos serviços públicos (Cavalheri, 2010;Skosireva, et al, 2014;Borysow, et al, 2014) (Engstrom, et al, 2016). Nesse sentido, a presença constante dos trabalhadores nos locais de vida da PSR se faz necessária e o uso do veículo se apresenta como estratégia importante.…”

“…Para se entender as determinantes presentes nos agentes, devemos recorrer ao conceito de trajetória, aqui entendido como a análise da série de posições sucessivamente ocupadas por um mesmo agente em um espaço ou campo (Bourdieu, 1996 (Massignam, et al, 2015 (Portugal, 2009;Post, 2007;Brasil, 2012a) e pelo estigma de que são vítimas, inclusive por parte de trabalhadores (Borysow, et al, 2014). Frente a esses desafios, alguns países têm adotado as estratégias de busca ativa e itinerância para superar limitações do modelo de demanda espontânea a esse grupo (Lemke, et al, 2010).…”

“…A articulação interserviços e intersetores se dá por meio de reuniões de rede e pelo compartilhamento de algumas ações com outras equipes de saúde e de assistência social. Tais aspectos têm sido considerados como relevantes para o trabalho junto às PSR (Borysow, et al, 2014;Engstrom, et al, 2016;Gama, et al, 2014) e apontam uma tentativa de superação da iniquidade (Vieira da Silva, 2009) pois a composição variada da equipe e ações articuladas com outros serviços possibilitam a adaptação do cuidado às necessidades do seu público alvo.…”