Representações de profissionais da saúde mental sobre sexualidade de pessoas com transtornos mentais

Abstract

Representations by mental health care professionals about the sexuality of people with mental disabilities. Among the obstacles confronting the promotion of sexual health in the mental health field is the difficulty of professionals to deal with the topic of sexuality. This creates barriers that prevent people with mental disabilities from expressing their needs and questions about the topic, resulting in not addressing important issues that could contribute to more complete health care for this population. In the various types of care, there are representations by health professionals regarding sexuality and mental disability, which could contribute to or impede advances in health care. The objective of this study was to understand the representations about sexuality and people with mental disabilities by the professionals who work in mental health services in the public system of Minas Gerais. It is a qualitative study founded on the understanding of representations, as proposed by Alain Giami. The study was carried out using six focus groups with 54 public mental health care professionals in Minas Gerais, Brazil, in 2011, after receiving approval from the Ethics Committee at UFMG. The following central issue guided the discussion of the groups: Share what you think about the sexuality of people with mental disabilities. Reframed questions were used to more deeply investigate the central issue of the study. The analysis of the discussion of the focus groups was conducted using the Structural Analysis of Narration method. The results allowed for the identification of empirical categories divided into two theoretical groups: Cultural scripts and Education; Sexual health promotion and Vulnerability. There were representations where people with mental disabilities denied their sexuality, with expressed condemnation of activities considered abnormal, such as masturbation, homosexuality and sexual relations between people with mental disabilities. Health professionals believe that these means of managing their sex life are the everyday result of their own craziness, and are generally repressed and to which silence and distancing are preferred. The findings of this study point to the almost non-existence of promotional activities for the sexual health of people with mental disabilities, as well as limitations among those that do exist, related to the lack of preparation of participants, starting from their professional training. It was also recognized that there is a need to consider the psycho-social aspects involved in their sexual life and self-care so that sexual health is possible and safe for these individuals who have higher vulnerability. It is vital that health professionals be trained on sexuality, using new approaches and considering human rights and more complete mental health, such as integrating care principles.