Modelo de teleatendimento psicológico a adultos e pessoas idosas de comunidades tradicionais do Amazonas durante a pandemia da covid-19

Abstract

: The COVID-19 pandemic also impacted traditional populations. Initially, it was expected that the greatest impact would occur in the most populous regions of Brazil; however, the impact of COVID-19 was more significant in the Northern Region, particularly in Amazonas, where a large portion of traditional communities is concentrated. OBJECTIVE: To develop a model for psychological telecare for adults and elderly individuals in traditional communities. METHODOLOGY: Action research, approved by an ethics committee (CAE 479.142.21.1.1001.50-16). Conducted in partnership between the Open University of the Third Age and the Sustainable Amazon Foundation from May 2020 to December 2022. The study is divided into three components. The first part provides context before the COVID-19 pandemic related to mental health services and epidemiological indicators of indigenous and Afro-Brazilian populations in Amazonas. The second part describes the organization of a model for psychological telecare for traditional communities in Amazonas, structured based on previous telecare experiences. The third part presents a preliminary validation of the model applied in 16 municipalities across microregions of Amazonas. RESULTS: Pre-pandemic, mixed-race, black and indigenous ethnicities had low mental health care and suicide rates were higher than those in Brazil. The model was structured based on integrated strategies: tele-know, teleplanning, teleacting and teletransforming. Community Health Agents (CHA) bridged the gap between populations in need of care and professional psychologists. So that they could carry out this activity, 60 ACS were trained through tele-education. Results in general demonstrate the difficulty in accessing health services, including due to the physical distance from communities, lack of qualified health professionals, low levels of human development and cultural aspects can be factors impacting the mental health of populations during the pandemic. There were 469 psychological consultations carried out, the main complaints were: the main diagnostic hypotheses. We draw attention to the fact that 95% of people reported not having had contact or prior follow-up with psychologists. The main complaints verbalized by participants in relation to mental health, among them were anxiety, insomnia, family conflicts, headache, forgetfulness, irritability, stress and grief; in the diagnostic hypothesis we highlight anxiety, family conflicts, depression, physical and emotional exhaustion, stress and grief; Among this universe, elderly people are represented by 6%, a total of 28 participants, and their main complaints were anxiety, depression, stress and grief. CONCLUSION: This model is a pioneer in psychological telecare for traditional Brazilian communities. It is noteworthy that even though the universal and free healthcare system was implemented in 1988, the “SUS in the Forest” will only arrive if it follows digital and innovative paths.