Mental health care: how can Family Health teams integrate it into Primary Healthcare?

Guilherme Gryschek,Adriana Avanzi Marques Pinto

doi:10.1590/1413-812320152010.13572014

Guilherme Gryschek, Adriana Avanzi Marques Pinto

Open Access

https://doi.org/10.1590/1413-812320152010.13572014

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Abstract

Mental health is one of the responsibilities of Brazil's Family Health system. This review of literature sought to understand what position Mental Health occupies in the practice of the Family Health Strategy. A search was made of the scientific literature in the database of the Virtual Health Library (Biblioteca Virtual de Saúde), for the keywords: 'Mental Health'; 'Family Health'; 'Primary Healthcare'. The criteria for inclusion were: Brazilian studies from 2009 through 2012 that contributed to understanding of the following question: "How to insert Mental health care into the routine of the Family Health Strategy?" A total of 11 articles were found, which identified difficulties and strategies of the professionals in Primary Healthcare in relation to mental health. Referral, and medicalization, were common practices. Matrix Support is the strategy of training and skill acquisition for teams that enables new approaches in mental health in the context of Primary healthcare. It is necessary for Management of the Health System to take an active role in the construction of healthcare networks in mental health.

Highlights

In recent decades we have seen a significant increase in the areas covered by the Family Health Strategy (Estratégia de Saúde da Família – ESF) in primary healthcare (Atenção Primária à Saúde – APS) in Brazil, and of substitution of new services in mental health (MH), resulting, respectively, from the processes of the Health Reform and of the Psychiatric Reform[1,2]
A further 9% need occasional care for minor problems, grouped as ‘Common Mental Disorders’, which today may represent between one third and 50% of the demand of APS3,4. Adding this demand to the problems arising from alcohol and drugs, for which 6% and 8% of the population reportedly have a need for regular care, one can have an idea of the breadth of the problem to be dealt with in care for mental health[4]
It is known that the demand for mental health in basic healthcare has particularities and complexities that cannot be solved by the classical knowledge of Psychiatry[1], and this has resulted in new proposals for de-institutionalization of the care given to those with mental disorders: multi-professional team care, an integrated approach, accountability for the team linked to a community, an approach spanning sectors, and integration between the primary and specialized levels of the network[5]

Summary

Introduction

In recent decades we have seen a significant increase in the areas covered by the Family Health Strategy (Estratégia de Saúde da Família – ESF) in primary healthcare (Atenção Primária à Saúde – APS) in Brazil, and of substitution of new services in mental health (MH), resulting, respectively, from the processes of the Health Reform and of the Psychiatric Reform[1,2].

Results

Conclusion