Os reflexos da implementação da Residência Integrada em Saúde Mental Coletiva do Ceará na Atenção Psicossocial

Abstract

Introduction and Geral Objective: The National Policy of Permanent Education in Health (NPPEH) was responsible for the creation of Multiprofessional Residences in Health, lato sensu specializations, characterized by in-service teaching, education and interprofessional collaboration in the practice of health teams and active learning methodologies. The Integrated Residence in Collective Mental Health of the School of Public Health of Ceará (RCMH-SPH/CE) started the first group in May 2013, the second in 2014 and the third in 2015, with 53 vacancies made available annually. Thus, the general objective was to analyze the reflexes of the implementation of RCMH-SPH/CE in the psychosocial care of the municipalities of Aracati, Fortaleza, Horizonte and Iguatu-CE. Methodology: Descriptive, exploratory and analytical qualitative study, which included documentary analysis and semi-structured interviews as techniques for the construction of information and elaborated considerations. The mentioned municipalities formed the context of the study, since they welcomed the first and second class, allowing the scope of a more longitudinal view of the process. Intentional sampling was used, with a selection of social actors involved in the process, 34 participants: municipal health secretaries, mental health coordinators, RCMH-SPH/CE coordinators, service managers, field preceptors, CAPS professionals who interacted with residents and residents. We analyze the information through the Thematic Content Analysis, considering the theoretical discussions and the national guidelines of psychosocial care, the permanent education in health and the literature on education and interprofessional collaboration. The research followed the ethical precepts of Resolution 466/12 of the National Health Council. Analysis and discussion of results: The reflexes of the implementation of RCMH-SPH/CE on psychosocial care highlights the importance of NPPEH in the training of professionals committed to the development of the Unified Health System (UHS), the Psychosocial Care Network and the skills required to promote mental health. The new actions and the new projects carried out are represented by the interprofessional-integral-intersectoral tripod. The advances in psychosocial care were: social and health mapping of the territories of action; Mental health training for family health teams; Professional qualification of both residents and service professionals; Social participation in spaces of social control such as health councils; Implementation of actions to manage the clinic in the services; Increasing accessibility to psychosocial services and minimizing stigmas in relation to mental health. Regarding the challenges, part of the history and structure of the Brazilian Federation, part of municipal political facts, and, within this complexity, of the contradictions triggered by the civilizing project of UHS, we have: infrastructure and organizational processes of SPH-CE and municipalities insufficient to Guarantee of the ideal conditions for RCMH-SPH/CE theoretical and practical programming, highlighting the inadequacy or lack of financial incentive to teachers. Despite the efforts of the coordination center of RCMH-SPH/CE, we also noticed deficiencies in the pedagogical training of preceptors and the uncertainty regarding the continuity of the Residence to guarantee the longitudinality of actions and the continuation of the minimization of stigmas in the areas of activity. Final considerations: Despite the challenges encountered, we revealed innovations generated by RCMH-SPH/CE in the municipal health networks, showing this as a strategy of education and interprofessional collaboration for the promotion of mental health and the viabilization of psychosocial care.