Intervenções psicossociais para Transtornos Mentais Comuns na Atenção Primária à Saúde.

Abstract

Psychosocial interventions for Common Mental Disorders in Primary Health Care. Common mental disorders (CMD), especially anxiety and depression, are highly prevalent, in spite of difficulties in their classification. In Primary Health Care (PHC), represented in Brazil by Family Health Strategy (Estratégia de Saúde da Família), these conditions are not well detected, or treated. This results in burden for the patients, their families and communities, as well as causes social and economic losses. Integrating mental health care into primary care can diminish this situation. In this sense, the goal is to identify and analyze different kinds of psychosocial interventions currently adopted in PHC locally and internationally in order to provide care for mental suffering and CMD. Accordingly, a national and international literature review was conducted through LILACS and MEDLINE bibliographic databases. The identified interventions were gathered in two groups. In the first, was the more traditional type of treatment where a qualified professional performs the treatment face-to-face, while the second group was made of different arrangements where contact with the professional was reduced and his role was more of a facilitator than that of a leader, such as interventions that utilize lay people in healthcare roles, support for self-help, and automated systems or electronic treatment packages offered on the internet. Theoretically, Interpersonal Therapy, Cognitive-behavioral Therapy and Problem Solving Therapy anchored the interventions. In international PHC, the interventions are short and very structured, including a plan of action defined in a user manual. In Family Health Strategy, it was group interventions and Community Therapy (Terapia Comunitária) that stood out, which is a model developed in Brazil. It was verified that CMD gain more visibility as PHC gains more ground and establishes itself closer to the population. In foreign countries, the integration of mental healthcare in PHC is a process that is being consolidated and there is an increase in technical psychosocial interventions, while in Brazil, the tie between PHC and Family Health Strategy is more recent and there isn t a standard of actions set in place. Insufficient or controversial results made it impossible to arrive at a conclusion as to which are the best interventions, however the prevalence of CMD and the potential for care in PHC demand that the research continues.