Abstract
The present chapter discusses mental health assistance in rural contexts, based on the experience of a psychologist who supports Primary Health Care (PHC) in a small Brazilian town. It questions the exercise of Psychology in rural areas from the experience of building the care of mental health by mental health specialized support to the family health teams, emphasizing the strategic importance of the bond between teams and users. Special attention is paid to the extended clinical practice due to the relevance of psychosocial aspects in the concepts of health/illness observed in rural areas. This paper also aims to contribute to reflections upon the health-care permanent education process in PHC.
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Notes
- 1.
Brazilian Universal Health System, which provides free universal health access to the population.
- 2.
Network whose aim is the “creation, expansion and articulation of health care units to people who suffer from mental disorders or who have needs yielding from crack, alcohol and other drug use, within SUS” (BRASIL, 2011).
- 3.
Within SUS, the Family Health Strategy (Estratégia Saúde da Família – ESF) is considered the privileged organizer of Primary Health Care (PHC). Its teams, called Family Health teams (equipes de Saúde da Família – eSF), are composed of doctors, nurses, nursing technicians, dentists, oral health technicians and auxiliaries, and Health Community Agents (Agentes Comunitários de Saúde – ACS), who are responsible for a certain area and its respective population. The ACS is a medium level professional who has hybrid characteristics; they are at the same time a health professional and a dweller of the area where the Health Unit is located, i.e., they are also users of the ESF. Among their functions, which count on the supervision of an eSF nurse, are identifying collective and individual risk situations, guiding families and facilitating access to health service.
- 4.
The Family Health Support Cores (Núcleos de Apoio à Saúde da Família – NASF) are the interprofessional teams that work on PHC aiming to increase resolve of reference teams, through specialized support in areas such as Mental Health. In 2018, the name was altered to “Expanded Family Health Care and Primary Care Core” (Núcleo Ampliado de Saúde da Família e Atenção Básica” – NASF-AB).
- 5.
We understand that this territory is a living environment that, on the one hand, has a dimension of a territory that is shaped as a geographic location, a populational profile interwoven by sociocultural factors; this territory is defined, above all, as living for having a dimension that is not objective, but an expression process evidencing its processual and qualitative character”. “It is thus this living, processual and qualitative dimension that makes the territory with and on which we operate in the health field, an existential territory” (Vieira & Neves, 2017: 28).
- 6.
Accommodations designed for teams to help service in rural zones.
- 7.
The collective approaches were not successful due to both the teams’ and users’ logistic and assistance difficulties, resulting in insufficient time to meet the great users’ demand, who seemed to prefer the private space of individual care with professionals. We also understand that contrary to the management’s expectations of the collective approaches, at the time it doesn’t seem to be technically and therapeutically accurate to resort to the “team” in order to cater for the needs of the growing demand of users in mental suffering, according to a perspective that understands team as just a strategy to provide medical care to more people in a short time.
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de Castro, B.P., Penido, C.M.F. (2021). Psychology in Rural Contexts: An Experience of Mental Health Specialized Support to Family Health Teams. In: Leite, J.F., Dimenstein, M., Dantas, C., Macedo, J.P. (eds) Psychology and Rural Contexts. Springer, Cham. https://doi.org/10.1007/978-3-030-82996-4_5
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