Desafio para a atenção básica: incorporação da assistência em saúde mental

Abstract

The objective of this study was to evaluate mental health care provided within a primary health care setting. The study was conducted in a Primary Health Care Center (PHC) in the city of Sao Paulo, Brazil. A comparative study was made between pediatricians' diagnosis of mental health problems and those identified by the Child Behavior Checklist (CBCL) in children (5-11 years) from August to October 2000. Eleven pediatricians were interviewed for more in-depth analysis. The study analyzed 411 patient charts and held 206 interviews with the children's parents. Analysis of the resulting data shows that the pediatricians provided a diagnosis of mental health problems in 17.5% of the children examined. When compared with probable mental health problems identified by the CBCL, only 25.3% of the children were diagnosed by the physician as having mental health problems. Interviews with pediatricians identified difficulties in the definition and conceptualization of mental health problems, lack of organization in the referral system, and insufficient technical support.

Saúde mental infantil na atenção primária à saúde: discursos de profissionais médicos

“…Ainda que voltados para o atendimento integral das necessidades da criança, nota se fragmentação das ações setoriais, com di ficuldades marcantes para contemplar demandas para além das suas responsabilidades específicas (Ribeiro, 2003;Lauridsen Ribeiro, 2006;Ribeiro, 2009). A integração e a cooperação intersetorial são importantes para que a criança, que demanda cuidados múltiplos e interdependentes, possa ter suas necessidades atendidas enquanto sujeito integral.…”

Estudo de comorbidade: sofrimento psíquico e abuso de drogas em pessoas em centros de tratamento, Macaé - Brasil

“…Se considerarmos que problemas de saúde mental que não preenchem critérios para o diagnóstico de transtornos mentais propriamente ditos têm altíssima prevalência, os riscos decorrentes desta associação ficam ainda maiores. Estudos brasileiros [12][13] indicam, por exemplo, que sintomas psiquiátricos que não preenchem critérios para o diagnóstico de transtornos mentais têm prevalência de 56% dentre a demanda das Equipes de Saúde da Família. Sofrimento psíquico é uma das categorias utilizadas para identificar os quadros constituídos por tais sintomas.…”

Apoio matricial em saúde mental: alcances e limites na atenção básica

“…For this analysis, we consider the definition of Travassos and Martins (2004): access is related to the easiness with which people get the care they need to solve their health problems. The following excerpts indicate this organizational achievement made possible by Matrix Support implantation.…”

“…In order to understand the configuration and the conformation of this model, it is necessary to analyze the worldly historical process of sanitary struggle, and evaluate mental health's dynamics and the offering of care available at the public health services. To evaluate is to measure, to compare and to establish judgments of value that will support decision making (Tanaka, 2004). In this sense, it implies in establishing criteria and parameters adequate to bespeak service capacity of intervening in problem situations.…”

“…However, we still have not reached an ideal situation for mental health care in primary health attention. Tanaka and Ribeiro (2006) have shown the difficulties in identifying problems in the offer of mental health support during regular primary care service. Their study identified that pediatricians who work in these services have reduced sensitivity to detect, intervene and/or refer children with mental health problems who go to the UBS -Basic Unity of Health (this in the first level of attention of SUS).…”