A saúde mental na perspectiva da estratégia saúde da família

Abstract

The historical and cultural roots of mental illness have always been guided by a strong rejection, discrimination, prejudice, violence, social isolation and lack of preparation of practitioners. This still happens in the network of health care, which includes the strategy of the Family Health (ESF). This study aimed to discuss the history of psychiatric reform in Brazil and strategic actions to mental health care at the Family Health Strategy. This is an exploratory study. Bibliographic search was performed in electronic databases: LILACS and SciELO using the key words: history, mental health, health strategy of the family. The modules of the Specialization Course in Primary Health Care Family and Line Guide on Mental Health of Minas Gerais were also used as source. It was found that the process of institutionalization of people with long history of psychiatric hospitalization has advanced significantly in Brazil, mainly through the Ministry of Health, which has guaranteed the security mechanisms for the reduction of beds and expansion of alternative services to psychiatric hospitals. With its proximity to families and communities, teams of family health are a strategic resource for coping with major public health problems such as injuries related to mental health of the individual. Initially, it is important the assessment of the individual. The psychosocial demands in primary care do not always appear clearly in the consultations, it is important to do thorough investigation within an bio-psycho-socio-spiritual approach, focusing on the individual as a whole. At all levels of the assistance, the reception is the first dimension to be considered. It is the first approach to treat individuals with mental disorder, it allows to listen, sympathize, empathize, to know the reality of the user and identify the possible inconvenience it may have. A home visit is another useful strategy in dealing with individuals with mental disorder, where mental health professionals can better understand their problem and family dynamics, as well as seek the involvement of relatives in treatment, monitoring of the user, integration into home, and identify any relationship of the user with the family unit. Reducing the number of admissions to psychiatric hospitals and the creation of policies guiding new ways to care for this population, as the expansion of day hospitals and outpatient health centers, the treatments were gradually transformed in groups which are the main feature in these therapeutic contexts. There are several possible practices in mental health that need to be further explored and the professionals involved in the ESF need to improve their technical and scientific knowledge about these practices. It is known that the ESF is structured in the logic of basic health care through new practices that is to affirm the inseparability between clinical studies and health promotion.