O escalonamento do cuidado como estratégia de organização da Rede de Atenção Psicossocial e fortalecimento da Atenção Primária à Saúde

Abstract

This thesis born of many provocations as for Psychosocial Attention Network development in Brazil. The foundation thesis was based in guidelines that promotes integration with other levels of care, in integral, ethical and unique care. In the context of mental health, we still witness big challenges to integrate psychosocial attention network – RAPS in health sector itself, which sometimes focuses on specialized care, or Psychiatric Hospital, or Psychosocial Support Centers. It is necessary proceed to other sectors and invest in intersectionality. It is necessary to look to inside and tidy up the house, if we want get success in this undertaking. In view of the fact of the emergency of this discussion and organization, this thesis presents four articles of literature review which set out to embark on the bases of this theme. To begin with a walk through the history of public health in Brazil and bare the different interests that continue to permeate public policy over the years. The second article goes into a diving on the way how the Brazilian National Health System (Unique Health System – SUS) has been building, since 1990 decade, to become universality, completeness and equity principles a reality on the life users. The third article narrows to a documentary analysis about how the Psychosocial Attention Network has been delineated by the Federal Government, wherewith published regulations between 2010 and 2020. The fourth article makes an integrative review about global scenario produced evidences, in the last five years, concerning how healthcare’s staggering has been used to contribute with mental health services organization in difference contexts. At last, a proposal to potentialize the mental health network organization was made in the chapter five, based on Brazilian National Health System (Unique Health System – SUS) organizational principles, on healthcare staggering model and focuses on Primary Health Care – APS role potentialization in the care strategies in mental health. Despite the evidence indicates efficacy of health systems organizational model to APS as healthcare network manager and healthcare’s staggering model as strategy to integrate mental health care, the proposed model needs that the applicability be adjusted, be monitored and be evaluated in Brazilian territory, with all its singularities and potencies.