Avaliação participativa da atenção à crise em saúde mental em serviço de urgência e emergência

Abstract

The field of mental health has undergone several transformations over the centuries, among the significant advances marked in history is the Brazilian Psychiatric Reform, which values humanitarian care carried out in freedom. In this sense, one of the weaknesses related to the strengthening of the reformist movement is the response to situations of psychological crisis in the urgent and emergency service. This study had the general objective of evaluating care actions in mental health crisis care in an urgent and emergency service. This is a qualitative study, based on the Fourth Generation Assessment. This method was based on a constructivist and responsive assessment with a hermeneutic-dialectic approach. The study location was an Emergency Care Unit, located in the interior of Rio Grande do Sul. The study participants were 18 health professionals who worked in that unit. To collect information, this research used observation and semi-structured interviews using the Hermeneutic-Dialetic Circle as techniques. The following steps were developed in the fieldwork: Contact with the field, organization of the evaluation, identification of interest groups, development of joint constructions, expansion of joint constructions, preparation of the agenda for negotiation and execution of the negotiation. The information was analyzed using the Constant Comparative Method. Regarding the legislation on research with human beings, Resolution No. 466 of December 12, 2012, all ethical precepts in force were respected. From the constructions of the evaluation process, four categories emerged: Access to mental health care in an urgent and emergency service; Feelings and perceptions regarding mental health care in an urgent and emergency service; Interventions carried out in mental health crisis care; Challenges in mental health crisis care. The care actions demonstrated in the evaluation process were physical and chemical restraints, the use of police force and the limited use of qualified listening. This research contributed to knowledge on the topic of mental crisis care and can be used in the continuing education of health professionals, focusing on urgency and emergency.