Rede de atenção psicossocial (RAPS) de Aracaju após 15 anos de implantação: reencontros, novos olhares e mais desafios

Abstract

Introduction: The Psychosocial Attention Network of the city of Aracaju was implemented in 2002 with strong federal induction through ordinances and resolutions that preached the Psychiatric Reform precepts and assigned to these the financial incentives for the implantation of services and programs. After a change in the political direction of the city in 2001, a manager involved with social causes assumes the municipal government that starts to reform mental health care by implanting the network of alternative services and reduction of psychiatric beds. After 15 years of implementation it is necessary to raise hypotheses about how this network was implemented and how the service care management is composed, in addition to which inter-sectoral actions are implemented. Objective: To evaluate the distance between the Prescribed Mental Health Policies and the process of implementation of the Psychosocial Care Network (RAPS) in Aracaju, from July 2017 to June 2018. Methods: This was a study using a quantitative-qualitative methodology. For this purpose, 14 points of attention were selected for Psychosocial Attention Network (RAPS) in which direct observation, documentary analysis and questionnaire application were performed with managers and service professionals. The data were analyzed quantitively using the SPSS software and then triangulated for its analysis. Results and analysis: from the material analyzed the following components were identified in the management of the care and organization of the services: implanted host and daily operation, there is no queue for medical care, preparation of individual therapeutic projects (PTS), device use of linking users (reference technicians), performing essentially group actions, attending to family members, offering overnight accommodation for the most serious cases. In hospital and emergency and emergency components, a distance was identified between federal guidelines regarding ambience and physical structure and team composition. Intersectoral actions happen informally, there are no spaces for pacing of goals and construction of collective actions in the territory. Conclusions: the psychosocial care network fully complies with the federal prescriptions and the guidelines of the Brazilian psychiatric reform. It was implemented considering the local historical reality. Many advances have been perceived over the years, such as reducing the number of beds of asylum features. However, there is a need to feed workers and managers daily into the objectives of RAPS, which should mainly follow the guidelines of the Psychiatric Reform regarding the de-institutionalization and psychosocial rehabilitation. Final considerations: Managers are advised to invest more in qualifying the linkage of professionals in health services, investing in supervision of contracted goals with providers so that services offer what RAPS demands and not iatrogenic mental health practices. Increasing the offer of permanent education in a systematic way, so that the goals of work in mental health are always reaffirmed within the minds and hearts of those responsible for care.