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Psychosocial Rehabilitation and Family Health Strategy: Challenges in mental health care.

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Author(s):
Mara Soares Frateschi
Total Authors: 1
Document type: Master's Dissertation
Press: Ribeirão Preto.
Institution: Universidade de São Paulo (USP). Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto (PCARP/BC)
Defense date:
Examining board members:
Carmen Lucia Cardoso; Magda Diniz Bezerra Dimenstein; Toyoko Saeki
Advisor: Carmen Lucia Cardoso
Abstract

The Family Health Strategy (FHS) has stood out as an important alterative for (re)inserting people in mental suffering into society, in accordance with the Brazilian Psychiatric Reform. Psychosocial rehabilitation is understood as an approach aiming at the subjects emancipation, reduction of discrimination, appreciation of individual and social capabilities and the creation of a long-term support system. The objective of this study was to learn and understand the actions developed by the FHS in terms of psychosocial rehabilitation in mental health, from the perspective of professionals, users and families. Data were collected from two Family Health Units (FHUs) in Ribeirão Preto, São Paulo state, and study participants were 26 professionals, 3 users and 2 family members. Open individual interviews and participant observation were the instruments used for data collection. The material was submitted to analysis following the qualitative approach, and the Thematic Content Analysis was used. The analysis allowed for the construction of six categories, namely: 1) Contexts and relationships: Needs pointed as being the reason for reaching the FHS for help; 2)Actions: the challenge of delivering mental health care in the units territory- indicating the actions developed by the FHUs, that is, traditional strategies, qualified listening, longitudinal care, teamwork, and collective strategies; 3) The contact with mental suffering and the training for this work: paths to transform the practices suggesting that looking at the person in mental suffering, in his/her multiple and complex existence, enables transformations in the practices by demystifying madness; 4) Difficulties found in the mental health care process pointing to the lack of technical and psychological preparation, the excessive demand and the insufficient network as possible hindrances in the work processes; 5) Evaluation of the mental health care provided by the FHUs indicating that, from a traditional clinical perspective, the services were considered effective and appropriate, however, the interviewees evidenced a process of transformation of the practices, demonstrating the need for making progress in psychosocial strategies; 6) Transformations in mental health care: Conceptions of the participants regarding the person in mental suffering and the process of making deinstitutionalization and psychosocial rehabilitation feasible approaching the meanings attributed by the interviewees to mental suffering and to the care processes, showing that such understandings interfere in the established practices and conducts. The results showed that mental suffering is correlated to the context and to the relationships established among people. Services are advancing towards more dialogical and spontaneous strategies, however, these strategies are still placed into practice individually. In conclusion, the process of transforming practices is slow and implies overcoming the daily traps that make it difficult to invest in actions that transcend traditional strategies, advancing towards the collective and searching for new ways of thinking and doing health. In this sense, this study provides progress regarding the feasibility of care practices in mental health in the territory of FHUs, aiming at committing to people throughout their life journey. (AU)

FAPESP's process: 12/13720-9 - Psychosocial Rehabilitation and Family Health Strategy: Challenges in mental health care.
Grantee:Mara Soares Frateschi
Support Opportunities: Scholarships in Brazil - Master