Desafios na construção de uma Rede de Atenção Psicossocial no município de Manaus (AM): discursos e práticas de gestores e profissionais.

Abstract

Over the last two decades there has been a significant reorientation regarding the attention to individuals with mental disorder, through the creation and expansion of care services with the purpose of replacing the logic exclusively focused on the hospital structure to a psychosocial care model, diversifying the therapeutic approaches and creating new action spaces. The present study aims to analyze the main challenges in the development and operationalization of a Psychosocial Care Network in the city of Manaus, according to the recommended model by mental health policies. It is a qualitative field research, with an exploratory and descriptive approach, developed in the first semester of 2018. The units of the study have been the State Healthcare Department, the Municipal Healthcare Department and the Psychosocial Care Centers. The research had participation of healthcare professionals, service managers and management representatives involved in the Psychosocial Care Network operationalization. The data collection has occurred through a semi-structured interview script, containing five questions that lead to the research object understanding. All interviews have been recorded and transcribed in full for further analysis. The obtained data has been evaluated by the Bardin thematic analysis, with the following analytical categories definition: characterization of the Mental Health care network and difficulties in the network work operationalization. The Psychosocial Attention Network of Manaus has been characterized as low connectivity using poorly defined integration strategies, prevailing the member s personal contacts network and as insufficient due to the low coverage of services, which the existent ones, have been made via judicial intervention. Regarding the challenges pointed out, highlights to the difficulty of dialogue between the different management bodies and the lack of integration of mental health actions in the scope of Primary Attention for Healthcare, with the focus of actions still maintained in the Psychosocial Care Centers. It is concluded that the Network of Psychosocial Attention in Manaus has scattered attention points, trying to act within its possibilities, instead of networking, making necessary to define leaderships and the building of a more cohesive movement for the municipality mental healthcare with the strengthening of the social control mechanism.