A integração da saúde mental na atenção primária à saúde no Brasil
Primary health care is the preferred entry point for the Health Care Networks, including the Psychosocial Care Network. In Brazil, this level of care represents 80 to 90% of health problems of its enrolled population. However, the organization, offer, and access to mental health services in prima...
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| Formato: | doctoralThesis |
| Idioma: | pt_BR |
| Publicado em: |
Universidade Federal do Rio Grande do Norte
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| Endereço do item: | https://repositorio.ufrn.br/handle/123456789/51941 |
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| Resumo: | Primary health care is the preferred entry point for the Health Care Networks,
including the Psychosocial Care Network. In Brazil, this level of care represents 80 to
90% of health problems of its enrolled population. However, the organization, offer,
and access to mental health services in primary care have barriers and gaps.
Therefore, this study generally proposed to evaluate factors associated with the
integration of mental health in primary health care in Brazil and specifically aimed (1)
to analyze the relationships between the provision of primary care and
socioeconomic indicators for equity in access to health for people with mental
disorders in Brazilian capitals; and (2) to analyze the association of criteria
agreement and flows between Family Health and NASF teams for collaborative care
in mental health in capitals and non-capitals of Brazil, considering the offer of
processes at the point of primary care of the Psychosocial Care Network at SUS in
municipalities with different structures and population sizes for its effectiveness. This
is an observational study based on secondary data from the third cycle of the
External Evaluation of the Program to Improve Access and Quality of Primary Care
and the Atlas of Human Development in Brazil, with two association studies: (1) for
primary care relationships and socioeconomic factors for equity in access to mental
health in Brazilian capitals; and (2) for the effectiveness of the agreement on criteria
and flows of collaborative mental health care in primary care in capital and noncapital cities. In drawing, (1) findings indicate associations between the organization
and supply of primary care with the municipal human development index and per
capita income. In design, (2) prevalence ratios of negative associations showed
protective factors for matrix support actions and follow-up at the Psychosocial Care
Center, management of psychopharmacotherapy, provision of other therapeutic
actions, care process for users of psychoactive substances, and provision of
activities to prevent the use of psychoactive substances. However, the provision of
primary mental health care is correlated with favorable socioeconomic factors for
equity in access to the Psychosocial Care Network in the Unified Health System; and
collaborative mental health care in primary care was effective, where capitals
demonstrate a protective factor compared to non-capitals in Brazil. Such evidence
validates the effectiveness of primary mental health care through community or
territorial-based services in a country with historical regional disparities and
inequalities, a continental dimension, and the largest national and public health service. |
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