ABSTRACT
The approximation to the knowledge about the Care Management in mental health
awakens constant restlessness when it comes to its effectuation. Meanwhile, it is
noticeable that the manner in which the professional actuation, the practices
organization and the dialog between the health services, it is essential to the
construction of an integral and resolute attention. In that manner, it is achieved the
comprehension of the care management as correspondent to the way in which the
attention production in health, regarding the form in which this care is developed and
is organized in the interaction that takes place between the subjects. It is the
objective, in a general sense, to comprehend the mental health care management in
the interconnections between the Psychosocial Attention Centre (PAC) and the
Family Heath Strategy (FHS), specifically regarding the professional, organizational
and systemic dimensions of this care. It regards a study of qualitative nature,
because it highlights all the dimension of the meaning that the human behavior has.
Aspect that in an apprehension from the hermeneutics analysis, achieves an
amplified and deeper look to the investigated reality. The research was conducted in
the municipal area of Fortaleza, capital of the Ceara state, in the northeast region of
Brazil, specifically, in a PAC and in a Basic Unity of Health (BUH), located in the
administrative area of the Regional Executive Office IV. The participants were users
and health professionals, chosen for having singular experiences regarding the
process of health-sickening-care and for being part of the Attention Network in Mental
Health (ANMH). For the data collections, there were used two technics: the interview
in deepening and the observation. The analysis and data interpretation plan was
oriented by the hermeneutics analysis of the interviews and observation. The ethical
precepts of the human involving research were followed. The study was submitted
and approved by the Research Ethics Committee (CEP) of UECE, with the ruling Nº
122.324. The discussion and presentation of the results followed the reflexive
perspective over the analyzed scenario. The investigated reality revealed limitations
and challenges to the construction of a resolute care, such as: the demand excess,
the centrality in programmatic solutions and medication; the low rate of
communication between the professionals of the FHS; the flaw in the communication
between the services; the limitation of access to users in the FHS; the insufficiency of
the processes of professional formation; and the lack of material resources and the
low quality work relations. Despite this challenges and fragilities, the users consider
PAC a welcoming space in which they feel cared for. It was highlighted as a place
that cares about the subject quality of life and it is seen as a support to deal with the
challenges of the daily life. Regarding the FHS, it was identified that the actions of
mental health are not welcomed, and that the users do not see it as a caring space.
However, the Basic Attention is understood as a place of potentiality and, in that
sense, it is possible to comprehend, by means of dialog, that a (re)structuration of the
practices might happen, making the attention more resolute, whether by means of a
(re)organization of the formative processes, or by means of a political (re)orientation,
that makes the care flow more coherent.
Keywords: Mental Health, Integral Assistance to Health, Health Management, Care.
