Saúde mental dos agentes comunitários de saúde no Brasil: uma revisão de escopo

Abstract

The mental health of Community Health Workers (CHWs) is an increasingly relevant topic in the field of Collective Health, as it involves a professional category that occupies a strategic position in consolidating Brazil’s Unified Health System (SUS) and implementing the actions of Primary Health Care (PHC). Acting as a bridge between health services and the community, these professionals experience daily situations of social vulnerability, human suffering, poverty, and violence, which expose them to high levels of emotional strain and psychological distress. This study aimed to map and synthesize the available scientific evidence on the mental health of CHWs in Brazil, identifying associated factors, assessment tools, and strategies for promotion, prevention, and care. It is a qualitative, exploratory, and descriptive scoping review conducted in accordance with the methodological guidelines of the Joanna Briggs Institute (JBI) and the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta- Analyses Extension for Scoping Reviews (PRISMA-ScR). The search was carried out in the SciELO and PubMed/MEDLINE databases, covering the period from 1991 to 2025. Twenty- four studies addressing the psychological distress of CHWs in different regional and institutional contexts were included. The results revealed a significant prevalence of mental suffering, anxiety, depression, and burnout syndrome, mainly associated with work overload, job insecurity, lack of psychosocial support, and insufficient institutional recognition. Among the protective factors identified, emotional bonds with the community, peer support, and a sense of belonging to the territory stood out as elements that contribute to resilience and coping with adversity. The care strategies described in the literature included self-care actions, listening and psychological support groups, continuing education initiatives, and participatory management practices aimed at valuing workers. It is concluded that the mental health of CHWs is a central dimension for the quality of Primary Health Care and for strengthening the SUS, requiring public policies that ensure decent working conditions, institutional psychological support, and recognition of the importance of these professionals in health care. This research contributes to consolidating the debate on caring for those who care and provides theoretical and practical support for managers and researchers committed to valuing and promoting the well-being of Community Health Workers.