Apoio matricial em saúde mental na estratégia de saúde da família em Fortaleza: ouro que não boia

Abstract

The present study aims to understand the Matrix Support in Mental Health with Family Health Strategy from its operation and senses constructed on this support by matrix supporters, professionals and managers of the Family Health Centers. The organization of the Matrix Support is complex and requires overcoming several challenges to enforce its implementation. This support contributes to promoting dialogue, exchanging knowledge and experiences among professionals from different areas of health, in order to extend the integrality of care. According to Vygotsky and Paulo Freire, there is an inseparable relationship in human beings between cognition and affectivity. Also between the social and cultural reality of the subject, the development of their consciousness and their construction of meanings about reality. Starting from these authors, it is understood that the formation of personal understanding of professionals about the Matrix Support is also permeated by the size of the objective reality experienced by them in their daily work in health. In this perspective, a construction of the data was performed within the theoretical framework of qualitative research, at three Family Health Centers in different areas of Fortaleza, with the following instruments: semi-structured individual interviews with coordinators, two focus groups with professionals and field notes. For discussion and data analysis we used the technique of content analysis. The survey results were organized from two dimensions of analysis: organization and operation of the Matrix Support in Mental Health at the Health Centers for Family and Senses built on the Matrix Support in Mental Health by practitioners. The first dimension has one category, describe about the organization and operation of Supporting in each Health Centre studied. The second dimension was subdivided into two: one for the senses of Family Health Strategy professionals and another for matrix supporters. Each of these dimensions has been subdivided into categories that emerged based on analysis of the material from focus groups. The results show that Matrix Support in Mental Health with a real involvement of professionals from the Family Health Strategy occurs sporadically at the three areas studied and many challenges must be faced in its implementation. In an area with a lower provision of Mental Health, proportional to its population, there was a greater challenge to achieve this Supporting. Professionals and managers indicated that the permanent education processes contribute to the organization and qualification of the Matrix Support, as well as greater involvement of Primary Care professionals with this support in two health centers. There was a polysemy of meanings built on the Matrix Support by practitioners that translated the potentiality of this support and the challenges to their achievement in Fortaleza. There is a need for a clearer and cohesive positioning of the management about the realization of Matrix Support to the integration of care networks for Mental Health and Primary Care in the city.