Atenção psicossocial de adolescentes : a percepção de profissionais da atenção básica e estratégica em saúde mental

Abstract

The historical path of the attention to the mental health of children and adolescents accompanied, in a particular and late way, the paths taken in the care of the adult population with psychic suffering, so that from the beginning of the nineteenth century there is recognition of the needs of care to the child and adolescent population, being, at first, the historical care delegated to the educational and social assistance sectors. However, from a few milestones, such as the Brazilian psychiatric reform and the declaration of human rights, it became possible to develop a new conception for childhood and adolescence, as well as the recognition of child and adolescent psychosocial care in the public policy arena. However, literature in the area has pointed to the scarcity of research that focuses on the assistance to Mental Health of adolescents, since they have presented significant indexes of psychic suffering, and indicate the need for more research that can subsidize the actions and policies aimed at this population. Thus, the present study aimed to identify how psychosocial attention has been given to the adolescent from the perspective of professionals linked to a service of Strategic Psychosocial Care (CAPS) and to Basic Health Care services (UBS and USF). In order to respond to the proposed objectives, a qualitative, descriptive and exploratory research was developed. The study was attended by 19 professionals from the Strategic Psychosocial Attention Service (CAPSij) and Basic Health Care (UBS and USF) and located in a medium-sized municipality in the interior of the State of São Paulo. Four data collection instruments were developed, two forms for characterization of professionals and services, and two semi-structured interviews for professionals. The data coming from the forms were analyzed in a descriptive way and those of the interviews were investigated by the Thematic Analysis, one of the techniques foreseen in the Content Analysis Method. The main results of the interviews with CAPSij professionals indicated that it acts as a gateway to the mental health demand of adolescents in the municipality, which is perceived as a challenge, considering the role of the service in the definition of eligible cases or not for the CAPSij. In addition, the participants also reported on the difficulties that the team faces with regard to the adherence of the adolescents users to the service, indicating the need for more strategies that facilitate the linkage of the same and the effectiveness of the work, as well as in relation to the users' families. The difficulty in enabling RAPS in the municipality was also a challenge pointed out by professionals. On the other hand, the data show the commitment of the participants in care actions focused on the premises of policies and the search for network articulation, especially with the Basic Health Care. The results of the interviews with the professionals of Basic Health Care Pointed out the challenges in the care and follow-up of the adolescent population in general, especially those who experience the psychological suffering that, according to the statements, hardly reach the service and, when they arrive, are referred to CAPSij. It was also observed that the activities carried out in adolescent ABS services are fundamentally curative, and health promotion and prevention actions are rare, as well as those of a network of care that, when they occur, are triggered by the CAPSij. Therefore, it was possible to verify with the present study that the psychosocial attention of adolescents in the investigated context is a field under construction and, currently, it occurs in CAPSij. It is hoped that the findings obtained may provide more subsidies for reflection and planning of policies and more effective interventions directed at the population of adolescents in psychological distress.