Apoio matricial em saúde mental: ferramenta para o cuidado integral

Abstract

The conception of Matrix support involves co-management strategies and support to operate in networks and in the health system, incorporating the concepcion extended health/disease process, the dialogue and the relational constitution of multiprofessional teams for coping the problems. In the field of mental health this methodology is considered strategic to guarantee the principle of completeness of the actions in health, because it aims to establish better coordination between the Centre for psychosocial care (CAPS) and the basic attention (AB). However, there are aspects of this relationship developed by CAPS III East of Natal, Rio Grande do Norte, in AB which need to be investigated, related to integration between teams of basic attention and supporters in to institute in the work dynamics the requests of the matrix support for sharing or discussion of cases. It is understood that the construction of this relationship is complex and procedural task which we consider to be potentially relevant to the strengthening of mental health policy in the city. Thus, this study aimed to analyze the matrix support in mental health from the point of view of professionals in the basic attention of Sanitary Districts East and South of Natal/RN and develop according to the gaps identified a technical product suggestion to qualify the Matricial Support, through the establishment of technologies (approach, relation, action, other). This is a study whose design is descriptive and exploratory nature of qualitative approach. The subjects of the research were the medical professionals, nurses, nursing technicians and community health agents (ACS), totaling 15 subjects, working in basic units with the model of the family health strategy. The option for research in health districts South and East in virtue of being the territory of the CAPS range III East. Data collection was used to interview with semi structured roadmap and for analysis the analysis technique of thematic content. To assist in the processing of textual data was used the ATLAS/ti software. The findings built from the transcripts of the interviews revealed three categories and subcategories, namely: a) what is said and what is meant, with their respective subcategories, which brings understanding of the subjects of research about the matrix support of mental health in the basic attention; b) what have and how to offer and its subcategories covering the characteristics, organization and contributions of the matrix support actions; c) limits and possibilities: what can we?, revealing the difficulties identified and the paths pointed out by the subjects of the research on the matrix support in mental health in basic care. Overall, the narratives reveal antagonistic conceptions in relation to knowledge and practices Matrix support. The results revealed the Matrix Support being offered by the CAPS and the Psychiatry residents HUOL/UFRN, though with limitations related to organizational, relational aspects and to request the Support flows, in the context both of the micropolitical in the production and management of care, as in macropolitíca. The suggestions points to aspects that promote continuity of support actions, the interprofessional work, the link, and the exercise of Support based on the design of the clinic expanded and not in the biomedical model, vertical. As technical product we suggest the strategy Matrix Support Regulated as practical and feasible intervention, able to favor communication processes from the request and coordination of AB, able to establishing flows, criteria for requesting and management of care. From this study, it is expected to contribute reflexively about the need to include new practices less fragmentary, discontinuous and circumstantial in the daily services and guaranteeing care in community-based mental health, especially of Christmas. And in this way contribute to the methodology Matrix support, for your potential transformer of working relationships between the teams, a strategy that extends the networking and that favors full, continuous care and quality for users the Health Unic System (SUS).