Qualificando o cuidado em saúde mental: caminhos possíveis através da integração da Atenção Primária com as equipes multiprofissionais de saúde mental e elaboração de indicadores qualidade

Abstract

The Health System model in Brazil recommends the integrality of primary health care (PHC), intervening in the most prevalent pathologies in the population referred to the team, including mental disorders. The high prevalence of mental health problems associated with deficient training contributes to the mental health treatment gap, in addition to a psicosocial care network poorly integrated between its levels of care. Primary health care is understood as the basis for reducing the difference between what the population needs in terms of health care and what is offered by the health network. The expansion of the scope of actions in PHC is fundamental, using new work processes (collaborative care and care escalation). This research explored the importance of analyzing the activities and interventions performed, which requires the construction of indicators of mental health care in PHC, enabling the follow-up of the patient, since its insertion in a health unit. The second point involves the presentation of a drawing of outpatient mental health care based on the principles of integrality, inserted in an intrinsic way by the Psychosocial Care Network (RAPS), enabling the construction of qualified mental health care. This project aims to present a quali-quanti study, with the purpose of studying mental health care in primary and secondary care in the integration model of multidisciplinary teams specialized in mental health. The Quantitative Part: Comparative case study in the electronic medical records of adult patients treated at two neighboring Primary Care units in the city of Rio de Janeiro between 2015-2016 and 2016- 2017.Qualitative Part: a case study of the Núcleo de Saúde Mental, an outpatient clinic. Secondary data for 2018 included number of care, patient flow, matrix support and SISREG. Two articles were elaborated: Mental Health Indicators in Primary Health Care: Evaluating the quality of access through the Case Detection Rate and Outpatient Mental Health Care integrated into Primary Care: Study of the case of the Mental Health Center of the Piquet Carneiro Polyclinic/ UERJ. At the end of the research, the need for integration between all levels of care in RAPS was evidenced, valuing the role of PHC in the trajectory that the patient does in the search for qualified care. It is necessary to invest in horizontalized work processes, which share the integral care of the patient, creating a dynamic health network, with clear flows for all people involved. In addition, investing in the qualification of professionals, enabling them to expand the scope of action of PHC, expanding patient access. Finally, to value the monitoring of the actions carried out, creating spaces for reflection to improve the work developed