Novos possíveis para atenção à crise grave em contextos rurais

Abstract

The research in question, based on a look at the Brazilian Psychiatric Reform, its advances and obstacles, sought to reflect and problematize the care of the severe psychic crisis in the sphere of Primary Care in the reality of a small city, specifically in the north of the state of Maranhão, in rural contexts. Problematizing that the care for users with severe psychological distress. It is under this scenario of concerns that the research questions we intend to investigate are inserted. 2- To identify the conceptions and meanings of the severe psychological crisis among the rural families and the needs of mental health care by the health services. 3- To produce analyzers about the limits and challenges of the Psychiatric Reform and Mental Health Policy in face of situations of severe psychic crisis in rural contexts. Regarding the methodological path, we used the guidelines of the Institutional Analysis (IA). The research was carried out with residents of rural areas of the city of Água Doce do Maranhão, users who had undergone psychiatric hospitalization and their families. In all, 9 people participated in the interviews: among the users, 2 women and 1 man, and among the family members: 2 men and 4 women. Interviews and field diaries were used as tools. After the interviews with the families and the mental health users, 3 blocks emerged, as follows: a) "The life that insists": living conditions in the rural area; b) "We are in the middle of the woods": the experience of a mental health user and family member in a rural area context; c) "The problem is not geographical, it is political": mental health care in the rural area. Which address the conceptions of mental crisis; the insufficient mental health care provided by the health services; the informal care provided by family members; and a still scarce coverage in relation to the Psychiatric Reform.