Ações em saúde mental na Atenção Básica em Saúde: manobras de conhecimento e negociação de sentidos

• Autor(a) principal: Rabello, Elaine Teixeira
• Data de Publicação: 2014
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações da UERJ
• Texto Completo: http://www.bdtd.uerj.br/handle/1/4690
• topic: Primary care; Mental health; Looping effect; Enactment; Atenção básica; Saúde mental; Looping effect; Enactment; CNPQ::CIENCIAS DA SAUDE::SAUDE COLETIVA

The aim of the study was to understand how the mental health demands in primary care attention are being identified and managed by family health team professionals in the city of Rio de Janeiro. Specifically, we were wanted to understand how these professionals, in a multidisciplinary team, act in daily attention considering the fluidity in concepts of mental welfare / mental malaise and how they deal with signs and symptoms that are not limited to physiological frameworks and are also closely related to social and territorial issues. In group interviews with five teams, we identified some diagnostic mechanisms operated by these professionals to negotiate the framework of a demand as mental and, then, choose and offer referral to this. Ian Hacking´s concepts of dynamic nominalism and looping effect and Annemarie Mol´s concepts of enactment and logic of care were taken as benchmarks for analysis and discussion. Given the considerations, we found out that the notions about mental health in this sphere attention are traded by the mobilization of knowledge that are unofficial but already circulate among the professional team. Professionals operate manoeuvres of knowledge in accordance with the theoretical/practical and personal experience acquired, always in some way endorsed by or often "translated" to the scope of biomedicine. Consequently, the actions engendered are based on a classification and biomedical standard, albeit adapted to local peculiarities and forms of care that are possible for each team. These data indicate that even supposedly humane, interdisciplinary, territorialized and less medicalized actions for mental health in primary care are delineated by the biomedical paradigm of scientific knowledge. This is still seen as a reference for professionals and is necessary to explain and act on the various types of demand.