Análise da implicação de apoiadores e trabalhadores da estratégia da saúde da família no apoio matricial em saúde mental

Abstract

This piece of work aims at analyzing the implication of matrix supporters and family healthworkers at Mental Health Matrix Support (MHMS) in Santa Luzia-MG and, for specificgoals, describing the implementation history of the MHMS in the municipality of SantaLuzia-MG and analyzing its institutional foundation, as well as comprehending the differentforms of implication of matrix supporters and family health workers at MHMS. TheInstitutional Analysis of René Lourau is the theoretical-methodological referential, notably itsconcepts of implication, comprehended as the relationship that the actors have with theinstitution, in this case, the MHMS. The implication of such researcher, also manager ofMHMS, is transversally analyzed within a research, supported by the diaristic writing. Thesurvey data were collected while consulting documents, focal groups with family health ofstrategy workers (ACSs, nurses, doctors) and matrix supporters (psychiatrists, psychologistsand psychology interns) and interviews with managers. Initially, the structural analysis ofnarrative technique, based on Demazière and Dubar, was used to organize the survey datacollected in focal groups and interviews. Afterwards, subsequent readings were performed toidentify the analyzers, elements that analyzed the MHMS institution and, through derivation,the actors´ implication. As a result, fragile pact of strategy matrix was observed, when it wasimplanted, between the Family Health Strategy and Mental Health. A scission founder wasidentified at MHMS institution in Santa Luzia, which repeats the area public policyambiguity, nationwide and contributed to resistance in relation to the MHMS. Supportersmaintain a disquieting relationship with MHMS due to the degrees of freedom andimprovisation and pleasure for their co-management. There is, eventually, overimplication inmatrix methodology. The implication of Family Health workers teams in MHMS is markedby the recognition of a higher degree of autonomy, security for mental health care and closerbonds with users which make them consider it a foundation against the epidemiologicalmagnitude of mental disorders workload. Supporters use knowledge to justify decisions aboutaspects of the work process, which generates conflicts among the teams.