Conquistas e dificuldades dos Núcleos de Apoio à Saúde da Família do município do Rio de Janeiro: a construção do cuidado colaborativo em Saúde Mental na Atenção Primária

Abstract

The importance of the integration of Mental Health care in the Primary Health Care, recognized in institutions such as the World Health Organization and the World Organization of Family Doctors (Wonca), to guarantee access to proper health care for people in suffering and mental disorders. Brazil, since the creation of Unified Health System (UHS), has been walking towards this way, with the consolidation of the Family Health Strategy (FHS) and the Psychiatric Assistance Reform as milestones in this process. The creation of the Family Health Support Centers (FHSC) in 2008, which work with the help of Matrix Support and the Psychosocial Care Network in 2011, were strategies to implement properly the proposed integration. The City of Rio de Janeiro, from 2009 to 2016, through management contracts with Social Organizations (SO), has expanded the coverage of FHS from 3,5% to 70%. This qualitative research, aimed to analyze the perception of Family Health Support Centers supporters and Matrix Supporters from the FHSC team in this city, about their work in sight of concepts of matrix support, horizontality and supervision. It has been conducted a narrative revision of the literature about these concepts, semi structured interviews with FHSC supporters from the 10 Programmed Areas (PA) from the city and one focal group with Matrix Supporters from 8 out of 10 APs, whereas the collected data analysis was realized by the method of Framework Analysis. Two papers were elaborated where it was possible to conclude that the FHSC Matrix Support work in the city of Rio de Janeiro received support from the municipal management through the SOs for its structuring, with the hiring of professionals, despite the gaps in the professional training graduated and post-graduate studies on UHS, FHS and matrix support. The management challenges faced vary according to the SO that manages the financial resources of PAs, the territorial characteristics of each unit (psychosocial vulnerability and violence), the number of professionals / demands and needs of the population, the insufficient training of the professionals of the teams the FHS and the FHSC and the psychosocial care network support. Despite the obstacles, the link between the FHSC teams and the work is evident, which translates into the pursuit of their professional improvement and their commitment to improving their practices.