LINE OF CARE OF MENTAL HEALTH: 4TH REGIONAL CENTER FOR HEALTH
POLICY1
MARTINS, Luciane Régio2; LARA, Michele Pivetta de3; ELY, Gabriela Zenatti4;
SILVA, Adão5 Ademir da.
1.INTRODUCTION
The present study is about Mental Health in Primary Care, in possibilities for
empowering of the Psychiatric Reformation, considering singularities and the users’
necessities.
The main goal is to identify how each city and town in the 4th Regional Center for
Health Policy organizes its net of integral care of people in psycho suffering and/or in alcohol
and drugs use, getting aware of difficulties and necessities.
In the perspective of the Psychiatric Reformation1 and Nets of Health Production
Building, it is known the necessity of recognizing how health is produced in territories, what
strategies and mechanisms are available, including freedom production, even live life in joy
for people2,3.
In the State of Rio Grande do Sul, the Resolution (CIB) 401/20114 institutes the policy
of incentive for Psychosocial Care Centers support, these start receiving a fixed value. The
Resolution 402/20115 institutes incentive for contracted beds of psychiatric internment and
also for people in use of alcohol and other drugs, in general hospitals, watched and
evaluated following net work proved. The Resolution 403/20116 institutes Support Teams in
Primary Health Care (NAAB Mental Health), for towns with population less than 20.000
inhabitants. And, the State Policy of Integral Care in Mental Health and Primary Care
1
Relato de experiência. Residência multiprofissional Integrada em Gestão e Atenção Hospitalar no
Sistema Público de Saúde. Universidade Federal de Santa Maria.
2
Apresentadora. Enfermeira, Coordenadora Regional da Política de Saúde Mental, Coordenadora
Regional da CIES, Coordenadora do Núcleo Regional de Ações em Saúde- 4ªCRS, Apoiadora
Institucional da PNH e Editora da Rede HumanizaSUS. Email: [email protected].
3
Psicóloga do Programa de Residência Multiprofissional Integrada em Gestão e Atenção Hospitalar
no Sistema Público de Saúde CCS/UFSM/HUSM.
4
Enfermeira do Programa de Residência Multiprofissional Integrada em Gestão e Atenção Hospitalar
no Sistema Público de Saúde CCS/UFSM/HUSM.
5
Enfermeiro Preceptor na Residência Multiprofissional Integrada em Gestão e Atenção Hospitalar no
Sistema Público de Saúde CCS/UFSM/HUSM.
1
instituted State Financial Support for implantation of Therapeutic Workshops Type I and II in
Primary Care (Resolution 404/2011)7, being done in the community territory. Also, the
Resolution 038/20128 which institutes Financial Support for Reducing Injuries.
Of these cities and towns, 21 have Family Health Strategy and 2 Support Teams of
Family Health (NASF), implanted in Santiago and São Francisco de Assis. Their majority, or
else, 24 have the population above 16.000 inhabitants; it means they can implant Support
Teams in Primary Health Care - NAAB Mental Health. Among them, 15 adhered to the
Improvement Program of Access and Quality in Primary Care (PMAQ).
Thus, the 4th Regional Center for Health Policy counts with 12 Psychosocial Care
Centers – CAPS (two in implantation: São Pedro do Sul and São Sepé). Of these, 4 are
CAPS I located in Júlio de Castilhos, Santiago, São Francisco de Assis and São Sepé; one
CAPS II, located in Santa Maria, which also has a CAPS i (for kids and teenagers) and 2
CAPS Alcohol and Drugs, having possibilities for a CAPS Alcohol and Drugs III; there are 2
other CAPS Alcohol and Drugs in Nova Palma and Santiago and one CAPS Alcohol and
Drugs Micro Regional in negotiation.
In the 4th Regional Center for Health Policy, there are 5 hospitals contracted with beds
for psychiatric internment and for people in use of alcohol and other drugs. In 2011, it was
visited these contracted hospitals to know their service, also quality and main difficulties,
which indicate important changes to be done (closed wards, minimal team incomplete, work
processes to be improved including Singular Therapeutic Projects).
In the 4th Regional Center for Health Policy there were 3 Therapeutic Communities,
and after checking them, one did not have its contract renewed.
Line of Care in Mental Health, Alcohol and other Drugs “The Care I need” of Rio
Grande do Sul State presents financial support for having therapeutic actions in Primary
Care opening dialog about where we produce mental health in the net?
2. METODOLOGY
A Technical Group of Mental Health was organized in the 4th Regional Center for
Health Policy, with Municipal Coordinators of Mental Health, Coordinators of Psychosocial
Care Centers, Municipal Coordinators of Primary Care, Coordinators of Family Health
Strategies, members of general hospitals contracted with the Public Health System of Brazil
(SUS), members of 2 Therapeutic Communities. The meetings happen from 40 to 40 days or
according to the necessity.
2
Meetings in the micro regions for organizing the Conductor Group of the Line of Care
in Mental Health are done for discussing about difficulties, necessities, possibilities of the
teams in Mental Health, and also the Health Care Net organization.
There are people of reference for each micro region, from different responsibilities in
the Regional. These people participate in the Monitoring and Evaluation Group in 4th
Regional Center for Health Policy.
In these last months there were meetings for presenting the Line of Care in Mental
Health and many projects were received, from meetings of the Technical Group of Mental
Health Regional and also contacts with the coordinators.
3. RESULTS
The projects sent to evaluation were 16 of Therapeutic Workshops in Primary Care, 4
Support Teams in Primary Health Care (NAAB Mental Health), with various themes, such as
guitar classes, flute classes, handcraft, dance, meeting groups.
Two Psychosocial Care Centers are being officially implanted, one in the city of Santa
Maria and the other in the town of São Pedro do Sul. In the town of São Sepé, it is being
implanted a Micro Regional Psychosocial Care Center for people using Alcohol and Drugs.
This will give support for the towns of Restinga Seca, Formigueiro, Vila Nova do Sul with its
official place in São Sepé.
It was done an official visit to the general hospitals and also Therapeutic
Communities.
4. CONCLUSION
The Line of Care in Mental Health of Rio Grande do Sul offers finantial support to the
services nets construction, but it is also defended that paths done by users must guide the
flow set, or else, that the users’ necessities turn priorities in SUS.
Bonds between professionals and users are done in relationships, in order to accept
the other as another person legitimate, in his radical difference, besides being a defeat, it is a
powerful way of building the confidence necessary to exchanges in Mental Health.
The Singular Therapeutic Projects construction is fundamental, following the
parameters of the National Humanization Policy, in which the subject participates in its
organizations and his subjectiveness is recognized as important in all process.
3
The Therapeutic Workshops and the Support Teams in Primary Health Care (NAAB
Mental Health) are mechanisms in opening of questions about Mental Health in Primary Care
very necessary for health nets production.
Mental Health services work well in the measure that they keep their doors opened,
welcome users in their necessities, as many times as it were necessary, until they are able to
also produce more autonomy and citizenship of rights.
REFERENCES
1.BRASIL. Lei 10.216/2001. Dispõe sobre a proteção e os direitos das pessoas portadoras
de transtornos mentais e redireciona o modelo assistencial em saúde mental. Disponível em:
http://www.planalto.gov.br/ccivil_03/Leis/LEIS_2001/L10216.htm Acesso em 30/04/2011.
2.BRASIL. Ministério da Saúde. Redes de produção de saúde / Ministério da Saúde,
Secretaria de Atenção à Saúde, Política Nacional de Humanizaçãoda Atenção e Gestão do
SUS. – Brasília : Ministério da Saúde, 2009. 44 p. : il. color. – (Série B. Textos Básicos de
Saúde).
3.BRASIL. Ministério da Saúde. Clínica ampliada e compartilhada / Ministério da Saúde,
Secretaria de Atenção à Saúde, Política Nacional de Humanização da Atenção e Gestão do
SUS. – Brasília : Ministério da Saúde, 2009. 64 p. : il. color. – (Série B. Textos Básicos de
Saúde).
4.http://www.saude.rs.gov.br/dados/1322059123024cibr401_11.pdf, acesso em 20/01/2011.
5.http://www.saude.rs.gov.br/dados/1322059146973cibr402_11.pdf, acesso em 20/01/2011.
6.http://www.saude.rs.gov.br/dados/1322059172294cibr403_11.pdf, acesso em 20/01/2011.
7.http://www.saude.rs.gov.br/dados/1322059196512cibr404_11.pdf, acesso em 20/01/2011.
8.RIO GRANDE DO SUL. Redução de danos, resolução 38/2012- CIB/RS.
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