O cuidado em saúde mental no encontro entre agente comunitário de saúde e usuário

Abstract

The Primary Health Care (PHC) in Brazil is made of teams of the Family Health Strategy (FHS), constituted by medical professionals, nurses, nurse‟s aides, dentists, dental assistants and Community Health Agents (CHA). As the first contact to the health care model, the PHC is the first contact of the users, including, the mental illness bearers, and the CHA being close to the community and to the families also become the first professional to identify and receive the cases of mental health. Under this theme, two studies were done. The first consisted in an exploratory integrative review study of literature that aimed in describing the knowledge in literature about the activities done and the insertion of the work of the Community Health Agents in Brazil and in other countries that have this professional in their health system. The structure of the review was: whole, accessible studies published during the period of 2010 to 2014, in English, Spanish and Portuguese that were found in the data bases SciELO, LILACS, MEDLINE, PubMed and Portal CAPES and that could answer the aimed purpose. After the detailed reading of the titles and abstracts, 240 articles were initially selected, and at the final of the procedure, the sample was of 19 articles. The results showed that the CHA have functions associated to the performance of various actions in the community; the CHA have fragilities in their work and their insertion in the job market is related to the country and health system in which they are part of. The second study was a field research, using mapmaking as method, that is based in the Schizoanalysis, philosophic theory of Gilles Deleuze and Félix Guattari, that is interested in mapping the strength lines that connects the object of study, in this care, aimed in mapping the care in mental health offered by the CHA. The research was done through three focal groups formed by 11 CHA of different teams of FHS, located in the city of Montes Claros, MG, selected randomly. The results point to the possibility of shifting in the way of caring of the CHA: the hard lines, “who takes care are the psychiatric and psychological professionals” and “caring without involving themselves” are leaded through flexible and escape lines, when they see themselves as also capable of caring of the health cases through listing and the need of thinking on the care that was offered to the user. Nevertheless, still, they are reterritorialized to a new hard line: “listening is not enough”. Therefore, this research points to the potentiality of the CHA in the mental health care in the PHC, being the CHA a worker who is able to invent their subjectivity and, consequently, of Psychiatric Reform. However, for so, the CHA need managing that contributes to new ways of caring, which would be interesting to be done in their own workplace to give them visibility and recognition.