Articulação entre serviços públicos de saúde nos cuidados voltados à saúde mental infantojuvenil

Abstract

The objective of this paper was to describe and analyze the articulation between children and adolescent mental health care interventions undertaken by teams working under the Family Health Strategy (FHS) and Psychosocial Care Centers for Children and Adolescents (CAPSI). In order to achieve these objectives, semi-structured interviews were conducted with five CAPSI and 13 FHS managers from five different regions of the city of São Paulo, Brazil. The 18 interviews were transcribed and analyzed froma hermeneutic perspective. It was found that interactions between the FHS and CAPSI occur mainly through referral of cases, matrix support or partnerships in cases concerning CAPSI. Obstacles, such as a lack of human resources, productivity goals and lack of training in mental health of FHS professionals were mentioned. The referral system and passing responsibility for mental health cases to specialized services and the hegemonic biomedical model and the fragmentation of care are common place in these services.

Solvability of mental health care in the Family Health Strategy: social representation of professionals and users

“…In the absence of organization, prevail unnecessary referrals and the consequent waiting list, shortage of professionals in the services and the low coverage of the FHS teams (16) .…”

Rede de cuidado em saúde mental: visão dos coordenadores da estratégia saúde da família

“…Integration between health services and these individuals is crucial to the achievement of the main purpose of the network: delivery of care to a given population (13) .…”

“…It promotes greater confidence among FHS professionals, who are sometimes insecure about their abilities in mental health care, and ensures permanent care in the network. The CAPS is a transitional care service, and, therefore, a coordinated action with the FHS is crucial to the transfer of care to the users' territory, which involves both health teams (13) .…”

“…It should be stressed that some professionals are committed to a practice more consistent with the psychosocial model, making partnerships with the community, working in network and promoting a dialogue between workers, which is necessary for effective care (13) .…”

Grau de integração da Atenção Primária à Saúde de município de pequeno porte na Rede de Atenção à Saúde

“…Para sua elaboração, o primeiro passo foi uma revisão da literatura, de relatórios, documentos e recomendações técnicas que trazem referências ao tema Axelsson, 2005Axelsson, , 2011Almeida, 2013;Giovanella, 2011;Almeida et al, 2010;Bernabé, 2003;Brasil, 2010;Browne et al, 2004;Conill;Fausto, 2007;Costa-E-Silva;Rivera;Hortale, 2007;Davies et al, 2009;Delfini;Reis, 2012;Hartz;Contandriopoulos, 2004;Hébert;Veil, 2004;Hofmarcher;Oxley;Rusticelli, 2007;Mendes, 2011;Núñez;Lorenzo;Navarrete, 2006;OPS, 2011;Paho, 2011;Rosen;Ham, 2009;WHO, 2008). Posteriormente, elaboraram-se esboços dos possíveis componentes da matriz com a finalidade de se avaliara permanência, inclusão ou exclusão de indicadores e parâmetros.…”