Trabalho, Educação e Saúde - TES (Work, Education and Health) is an open access scientific journal, edited by the Joaquim Venâncio Polytechnic School of Health, from Oswaldo Cruz Foundation.

Mental health and primary health care: territory, violence and the psychosocial approaches challenge

  • Nina Isabel Soalheiro dos Santos Prata
  • Daniel Groisman
  • Desiane Alves Martins
  • Elaine Teixeira Rabello
  • Flávio Sagnori Mota
  • Marco Aurélio Jorge
  • Mariana Lima Nogueira
  • Renata Ruiz Calicchio
  • Renata Veloso Vasconcelos
  • Nina Isabel Soalheiro dos Santos Prata

    Fundação Oswaldo Cruz, Escola Politécnica de Saúde Joaquim Venâncio, Rio de Janeiro, RJ, Brasil.

    Daniel Groisman

    Fundação Oswaldo Cruz, Escola Politécnica de Saúde Joaquim Venâncio, Rio de Janeiro, RJ, Brasil

    Desiane Alves Martins

    Secretaria Municipal de Saúde de Duque de Caxias, Duque de Caxias, RJ, Brasil

    Elaine Teixeira Rabello

    Universidade do Estado do Rio de Janeiro, Instituto de Medicina Social, Rio de Janeiro, RJ, Brasil

    Flávio Sagnori Mota

    Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil

    Marco Aurélio Jorge

    Fundação Oswaldo Cruz, Escola Politécnica de Saúde Joaquim Venâncio, Rio de Janeiro, RJ, Brasil

    Mariana Lima Nogueira

    Fundação Oswaldo Cruz, Escola Politécnica de Saúde Joaquim Venâncio, Rio de Janeiro, RJ, Brasil

    Renata Ruiz Calicchio

    Fundação Oswaldo Cruz, Escola Nacional de Saúde Pública Sergio Arouca, Rio de Janeiro, RJ, Brasil

    Renata Veloso Vasconcelos

    Fundação Oswaldo Cruz, doutoranda Escola Nacional de Saúde Pública Sergio Arouca, Rio de Janeiro, RJ, Brasil



Abstract

This article aimed to discuss the challenges to the implementation of mental health actions in the Family Health Strategy in the context of deinstitutionalization and of the territorialization of care. We described, in the view of the family health managers and teams, the territorial context, forms of identification of the demands, and the mental health support and care practices. We also evaluated the challenges to building powerful psychosocial approaches and network care. The research field consisted of two territories in the municipality of Rio de Janeiro (Manguinhos and Complexo do Alemão), Brazil, with iconic features of the city's urban context, in the period studied (2009-2013). The researchers worked with qualitative and collaborative methodology strategies that included interviews with managers, focus groups with workers, and systematic visits to the field. The data collected showed specific trends, such as the accelerated expansion of the Family Health Strategy with impact on the work process; the discourse of the managers with evidence of opening for the inclusion of mental health in the Strategy; workers' narratives explaining their sense of unpreparedness and a low perception of the therapeutic potential of primary care; violence in the territories causing tension and ambivalence in relation to local authorities; direct association between mental health and violence in daily life.

Keywords

mental health,
primary care,
psychosocial approaches,
territory

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Copyright (c) 2022 Fundação Oswaldo Cruz, Escola Politécnica de Saúde Joaquim Venâncio

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