RESUMO
El presente informe tiene la intención de dar cuenta de las actividades desarrolladas en el marco de la Rotación Electiva de la residente de tercer año Luisina Miniaci por el Programa de Rehabilitación y Externación Asistida (en adelante P.R.E.A.), dependiente del Hospital Esteves del Ministerio de Salud del Gobierno de la Provincia de Buenos Aires. Además señala los aprendizajes más significativos y los aportes realizados desde el trabajo social, como así también desde la educación y promoción de la salud. La institución nombrada se encuentra ubicada en Temperley, Buenos Aires, y el período de rotación comprende desde el 28 de Marzo hasta el 17 de Junio del año 2022. (AU)
Assuntos
Rotação , Saúde Mental/tendências , Serviços Comunitários de Saúde Mental/organização & administração , Serviços Comunitários de Saúde Mental/tendências , Educação em Saúde , Promoção da SaúdeRESUMO
El siguiente artículo indaga las condiciones de articulación de la red socio-sanitaria en las prácticas de salud mental infanto-juvenil en el subsector público de salud en la Ciudad de Buenos Aires, siguiendo el hilo de políticas específicas de continuidad de cuidados en la red de servicios de salud mental en los últimos veinte años y las derivas presentes en la recepción de la llamada niñez en riesgo en sus recorridos de vida, singulares y colectivos. (AU)
Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adolescente , Planos e Programas de Saúde/tendências , Cuidado da Criança/provisão & distribuição , Cuidado da Criança/tendências , Serviços de Saúde do Adolescente/provisão & distribuição , Serviços de Saúde do Adolescente/tendências , Serviços Comunitários de Saúde Mental/provisão & distribuição , Serviços Comunitários de Saúde Mental/tendências , Saúde do Adolescente/tendências , Serviços de Saúde Mental/provisão & distribuição , Serviços de Saúde Mental/tendênciasRESUMO
Relato de la experiencia de los concurrentes de salud mental en el Centro de Salud y Acción Comunitaria (CeSAC) N° 9, del barrio de La Boca, y parte del área programática del Hospital Argerich. Se da cuenta de su recorrido por la institución, articulado con las preguntas que surgen luego de la formación como profesionales de la salud. Las autoras pensaron en la idea de autogestionarse como concurrentes un ciclo de formación en perspectiva de género en salud, y relatan parte de esta iniciativa.
Assuntos
Centros Comunitários de Saúde/organização & administração , Centros Comunitários de Saúde/tendências , Serviços Comunitários de Saúde Mental/tendências , Perspectiva de Gênero , Internato e Residência/tendências , Serviços de Saúde Mental/organização & administração , Serviços de Saúde Mental/tendênciasRESUMO
OBJECTIVE: to describe and analyze the role of expert nurses in mental health in the Family Health Strategy. METHOD: a qualitative study, with 20 Basic Health Units nurses of Teresina, Piauí. The information was collected through semi-structured interviews from March to May 2017 and analyzed using the content analysis method. RESULTS: it was found that the conceptions of the mental health disease process were based on the biological model, there was little communication between mental health and basic network, nurses did not feel qualified to work mental health and there were few mental health actions in Primary Care. Final considerations: it becomes urgent to implement public policies that articulate mental health and Primary Care, raising awareness and continuing education for nurses.
Assuntos
Serviços Comunitários de Saúde Mental/normas , Papel do Profissional de Enfermagem/psicologia , Enfermeiras e Enfermeiros/psicologia , Atenção Primária à Saúde/métodos , Reabilitação Psiquiátrica/métodos , Atitude do Pessoal de Saúde , Brasil , Serviços Comunitários de Saúde Mental/tendências , Humanos , Entrevistas como Assunto/métodos , Atenção Primária à Saúde/tendências , Reabilitação Psiquiátrica/normas , Pesquisa QualitativaRESUMO
OBJECTIVE: to analyze Cognitive Stimulation techniques effectiveness in the community and at home, in people with stabilized mental illness and their families. METHOD: an Integrative Literature Review, with inclusion criteria for primary studies that assess the Cognitive Stimulation techniques effectiveness in people with stable mental illness, older than 18 years, in the community and at home. Six articles were selected. RESULTS: improvement of cognitive abilities such as attention, work memory and executive functions was observed. No conceptual differences or results were found among Cognitive Stimulation programs for people with different pathologies; computer tools are increasingly being used; sample size is limiting gain analysis; the nurse's role has not been clarified; family gains were not studied. FINAL CONSIDERATIONS: the results obtained in this review reveal the need to know more about the theme.
Assuntos
Cognição/fisiologia , Transtornos Mentais/terapia , Serviços Comunitários de Saúde Mental/métodos , Serviços Comunitários de Saúde Mental/tendências , Humanos , Transtornos Mentais/psicologiaRESUMO
The contentious debate on evidence-based Global Mental Health care is challenged by the primary mental health program of Jamaica. Political independence in 1962 ushered in the postcolonial Jamaican Government and the deinstitutionalization of the country's only mental hospital along with a plethora of mental health public policy innovations. The training locally of mental health professionals catalyzed institutional change. The mental health challenge for descendants of African people enslaved in Jamaica is to reverse the psychological impact of 500 years of European racism and colonial oppression and create a blueprint for the decolonization of GMH. The core innovations were the gradual downsizing and dismantling of the colonial mental hospital and the establishment of a novel community mental health initiative. The successful management of acute psychosis in open medical wards of general hospitals and a Diversion at the Point of Arrest Programme (DAPA) resulted in the reduction of stigma and the assimilation of mental health care into medicine in Jamaica. Successful decentralization has led to unmasking underlying social psychopathology and the subsequent development of primary prevention therapeutic programs based on psychohistoriographic cultural therapy and the Dream-A-World Cultural Therapy interventions. The Jamaican experience suggests that diversity in GMH must be approached not simply as a demographic fact but with postcolonial strategies that counter the historical legacy of structural violence.
Assuntos
Política de Saúde , Transtornos Mentais/história , Pessoas Mentalmente Doentes , Colonialismo/história , Serviços Comunitários de Saúde Mental/tendências , História do Século XV , História do Século XVI , História do Século XVII , História do Século XVIII , História do Século XIX , História do Século XX , História do Século XXI , Hospitais Psiquiátricos/história , Humanos , Jamaica , Transtornos Mentais/terapia , Problemas Sociais/históriaRESUMO
This article analyzes spending on mental health by the Brazilian Ministry of Health between 2001 and 2014. It is documental research of the Brazilian Ministry of Health's databases. It analyzes the data using descriptive statistical analysis. Total spending on mental health for the period 2001 to 2014 shows a percentage increase in resources destined for outpatient care, but this increase is a reallocation from hospital services to community-based services and total resources for the mental health program remain at an average of 2.54% of the total health budget. Within outpatient expenditure, spending on medications remains high. Professionals committed to psychiatric reform fight to guarantee that a small fraction of the surplus appropriated by the state is directed towards social policies.
Assuntos
Serviços Comunitários de Saúde Mental/economia , Financiamento Governamental/legislação & jurisprudência , Reforma dos Serviços de Saúde/economia , Política de Saúde/economia , Unidade Hospitalar de Psiquiatria/economia , Instituições de Assistência Ambulatorial/economia , Instituições de Assistência Ambulatorial/legislação & jurisprudência , Instituições de Assistência Ambulatorial/tendências , Brasil , Serviços Comunitários de Saúde Mental/legislação & jurisprudência , Serviços Comunitários de Saúde Mental/tendências , Desinstitucionalização/economia , Desinstitucionalização/legislação & jurisprudência , Desinstitucionalização/tendências , Financiamento Governamental/tendências , Reforma dos Serviços de Saúde/legislação & jurisprudência , Reforma dos Serviços de Saúde/tendências , Gastos em Saúde/legislação & jurisprudência , Gastos em Saúde/estatística & dados numéricos , Gastos em Saúde/tendências , Política de Saúde/legislação & jurisprudência , Política de Saúde/tendências , Prioridades em Saúde/economia , Prioridades em Saúde/legislação & jurisprudência , Prioridades em Saúde/tendências , Humanos , Direitos do Paciente/legislação & jurisprudência , Unidade Hospitalar de Psiquiatria/legislação & jurisprudência , Unidade Hospitalar de Psiquiatria/tendências , Tratamento Domiciliar/economia , Tratamento Domiciliar/legislação & jurisprudência , Tratamento Domiciliar/tendências , Transtornos Relacionados ao Uso de Substâncias/economia , Transtornos Relacionados ao Uso de Substâncias/terapiaRESUMO
By studying the inclusion of artistic and cultural activities in the care provided throughout the history of public mental healthcare in greater São Paulo, Brazil, we can better understand and characterize the practices adopted in the Psychosocial Care Centers in the city today. Experiments carried out between the 1920s and 1990s are investigated, based on bibliographic research. The contemporary data were obtained from research undertaken at 126 workshops at 21 Psychosocial Care Centers in the same city between April 2007 and April 2008. The findings indicate that the current trend in mental healthcare, whose clinical perspective spans the realms of art and mental health and has territorial ramifications, has maintained some of the features encountered in earlier mental healthcare experiments.
Assuntos
Serviços Comunitários de Saúde Mental/história , Reabilitação Psiquiátrica/história , Arteterapia/história , Brasil , Serviços Comunitários de Saúde Mental/tendências , História do Século XX , História do Século XXI , Humanos , Saúde Mental , Psicoterapia/históriaRESUMO
Since 1997, public-sector behavioral healthcare in New Mexico has remained under continual transition. We have conducted qualitative research to examine recent efforts in NM to establish a recovery-oriented behavioral healthcare system, focusing on comprehensive community support services, clinical homes, and core service agencies. We examine how decisions made in the outer context (e.g., the system level) shaped the implementation of each initiative within the inner context of service provision (e.g., provider agencies). We also clarify how sociopolitical factors, as exemplified in changes instituted by one gubernatorial administration and undone by its successor, can undermine implementation efforts and create crises within fragile behavioral healthcare systems. Finally, we discuss findings in relation to efforts to promote wraparound service planning and to establish medical home models under national healthcare reform.
Assuntos
Serviços Comunitários de Saúde Mental/organização & administração , Atenção à Saúde/organização & administração , Reforma dos Serviços de Saúde , Política de Saúde , Assistência Centrada no Paciente , Política , Setor Público , Serviços Comunitários de Saúde Mental/tendências , Atenção à Saúde/tendências , Humanos , New Mexico , Pesquisa Qualitativa , População RuralRESUMO
BACKGROUND: Over the last three decades Brazil has developed a new community-based mental health policy. In this context it is important to reflect on the offers of care for users, and especially on how therapeutic projects are developed by professionals. OBJECTIVE: This study was conducted with professionals working in community-based mental health services to investigate and understand their views on the construction of therapeutic projects and compare them with the concepts and theoretical proposals in Brazil's Mental Health Policy Guidelines and a review of the literature. PARTICIPANTS: Thirteen professionals who worked in mental health services located in three cities of the state of São Paulo, Brazil. METHODS: Semi-structured interviews were conducted between September and November of 2009 to understand the views and mechanisms adopted by professionals in developing therapeutic projects. A bibliographical review laid the foundations for the theoretical research and for strengthening the basis of the data analysis. RESULTS: The professionals views are similar to those proposed in the relevant literature and Brazil's Mental Health Policy Guidelines. However, there is a need to invest in building new models to meet the needs of the population that requires mental health services. Clearer guidelines should be established to organize services and to provide adequate, sufficient training. CONCLUSIONS: The study suggests that attention and resources should be directed to strengthening training of professionals, and especially to qualifying the organization and administration of services in order to consolidate the new model.
Assuntos
Serviços Comunitários de Saúde Mental/tendências , Desenvolvimento Industrial/tendências , Desenvolvimento de Programas/métodos , Brasil , Política de Saúde , Humanos , Saúde Mental/estatística & dados numéricos , Pesquisa QualitativaRESUMO
Involuntary commitment and custodialization were the principal tenets of British colonial public policy provisions for the management of the violent, disturbed mentally ill in Jamaica and the West Indies. Over the fifty years following Jamaica's political independence from Britain, a community engagement mental health programme has developed through a decolonization process that has negated involuntary certification, incarceration and custodialization, has promoted family therapy and short stay treatment in conventional primary and secondary care health facilities, and has promoted reliance on traditional and cultural therapies that have been extremely successful in the treatment of mental illness and the reduction of stigma in Jamaica. Collaborations involving The University of the West Indies, the Jamaican Ministry of Health and the Pan American Health Organization have been seminal in the development of the decolonizing of public policy initiatives, negating the effects of involuntary certification that had been imposed on the population by slavery and colonization. This collaboration also catalysed the psychiatric training of medical, nursing and mental health practitioners and the execution of community mental health policy in Jamaica.
Assuntos
Política de Saúde , Transtornos Mentais/história , Pessoas Mentalmente Doentes , Colonialismo/história , Serviços Comunitários de Saúde Mental/tendências , História do Século XIX , História do Século XX , Hospitais Psiquiátricos/história , Humanos , Jamaica , Transtornos Mentais/terapia , Problemas Sociais/históriaRESUMO
Involuntary commitment and custodialization were the principal tenets of British colonial public policy provisions for the management of the violent, disturbed mentally ill in Jamaica and the West Indies. Over the fifty years following Jamaica's political independence from Britain, a community engagement mental health programme has developed through a decolonization process that has negated involuntary certification, incarceration and custodialization, has promoted family therapy and short stay treatment in conventional primary and secondary care health facilities, and has promoted reliance on traditional and cultural therapies that have been extremely successful in the treatment of mental illness and the reduction of stigma in Jamaica. Collaborations involving The University of the West Indies, the Jamaican Ministry of Health and the Pan American Health Organization have been seminal in the development of the decolonizing of public policy initiatives, negating the effects of involuntary certification that had been imposed on the population by slavery and colonization. This collaboration also catalysed the psychiatric training of medical, nursing and mental health practitioners and the execution of community mental health policy in Jamaica.
El compromiso involuntario y la custodialización eran los principios principales de las disposiciones de las políticas públicas coloniales británicas, para el manejo de los enfermos perturbados de sus facultades mentales y violentos en Jamaica y West Indies. Durante los más de cincuenta años que siguieron a la independencia política de Jamaica de Gran Bretaña, se ha venido desarrollando un programa de salud mental basado en el compromiso a través de un proceso de descolonización que ha invalidado la certificación involuntaria, el encarcelamiento y la custodialización, promoviendo en su lugar la terapia familiar y el tratamiento de estancias cortas en centros de salud de atención primaria y secundaria convencional. Asimismo, ha promovido la confianza en las terapias tradicionales y culturales que han sido sumamente exitosas en el tratamiento de las enfermedades mentales, y la reducción del estigma en Jamaica. Colaboraciones que incluyen a la Universidad de West Indies, el Ministerio de Salud de Jamaica, y la Organización Panamericana de la Salud han desempeñado un papel seminal en el desarrollo de iniciativas en materia de políticas públicas descolonizadoras, que anulan los efectos de la certificación involuntaria impuestas históricamente a la población por la esclavitud y la colonización. Estas colaboraciones también catalizaron el entrenamiento psiquiátrico de médicos, enfermeras, y profesionales de la salud mental, así como la ejecución de políticas comunitarias para el cuidado de la salud mental en Jamaica.
Assuntos
História do Século XIX , História do Século XX , Humanos , Política de Saúde , Transtornos Mentais/história , Pessoas Mentalmente Doentes , Colonialismo/história , Serviços Comunitários de Saúde Mental/tendências , Hospitais Psiquiátricos/história , Jamaica , Transtornos Mentais/terapia , Problemas Sociais/históriaRESUMO
As mudanças contemporâneas produzidas pelas novas políticas de saúde mental colocam como desafio central a construção de serviços substitutivos ao hospital, desenvolvidos no contexto da atenção na comunidade. Tal desafio exige um complexo conjunto de condições que implicam, dentre outros fatores, no desenvolvimento de uma nova cultura ética e técnica capaz de criar respostas inovadoras para atenção às pessoas com transtornos mentais. É nesse cenário que se deve discutir a pertinência e a importância do projeto elaborado por Thornicroft e Tansella no "Modelo de Matriz" que é apresentado neste artigo. Nele os autores trazem contribuições fundamentais para alicerçar a nova cultura de serviços e formação profissional pretendidas pelo processo de reforma psiquiátrica. Este modelo pode ser utilizado no planejamento, avaliação e modelagem dos serviços além de trazer instrumentos úteis para a pesquisa em serviços de saúde mental.
The contemporary changes produced by the new mental health policies place as main challenge the construction of substitutive services to hospital, developed in the context of care in the community. This challenge requires a complex set of conditions involving, among other factors, the development of a new ethical and technical culture able to create innovative responses to care of people with mental disorders. It is in this scenario that we must discuss the relevance and importance of the project developed by Thornicroft and Tansella, "The Matrix Model", presented in this paper. There, the authors bring fundamental contributions to underpin the new culture of services and professional training sought by the process of psychiatric reform. This model can be used in planning, evaluation and modeling of services; in addition, it can bring useful tools to the research in mental health services.
Assuntos
Planejamento , Prática Profissional/ética , Reforma dos Serviços de Saúde/classificação , Reforma dos Serviços de Saúde/tendências , Serviços Comunitários de Saúde Mental/tendências , Serviços de Saúde Mental/tendências , Serviços de Saúde Mental/ética , Terapia Ocupacional/educação , Terapia Ocupacional/tendênciasRESUMO
The following paper explores how working in Venezuela, a country that has gone through 20 years of economic and political problems, has highlighted the gap between clinical and community approaches in dealing with the sufferings of our consultants. Our efforts to develop theoretical and practical tools that can address the historical and political dimensions of people's lives are reviewed. These efforts illustrate how the community paradigm can help expand clinical perspectives, thus allowing a practise which can address the needs of people who have neither the time nor the economic means to engage in a traditional therapeutic relationship. The shift in perspective, the revision of our "therapeutic" stance and the use of de-naturalisation and problematization are illustrated.
Assuntos
Serviços Comunitários de Saúde Mental/tendências , Política , Psicologia Clínica/tendências , Humanos , América Latina , Psicanálise/tendênciasRESUMO
Antecedentes: El cierre de asilos e instituciones para pacientes con enfermedades mentales, acompañado de las políticas gubernamentales que se centran en la reducción del número de camas hospitalarias para los pacientes con enfermedades mentales graves y que están a favor de la prestación de asistencia en una variedad de ámbitos extrahospitalarios, respalda el fundamento para la atención comunitaria. Un paso importante hacia la atención comunitaria ha sido el desarrollo de equipos comunitarios de salud mental (ECSM). Objetivos: Evaluar la efectividad de los Equipos Comunitarios de Salud Mental (ECSM) en el tratamiento de cualquier tipo de enfermedad mental grave en comparación con el tratamiento estándar de estas enfermedades sin estos equipos. (AU)
Assuntos
Transtorno da Personalidade Esquizoide/terapia , Centros Comunitários de Saúde Mental , Serviços Comunitários de Saúde Mental/métodos , Serviços Comunitários de Saúde Mental/provisão & distribuição , Serviços Comunitários de Saúde Mental/tendências , Saúde Mental/tendênciasRESUMO
This paper reviews the development of mental health services in the Cayman Islands throughout a twelve-year period (1989 to 2001). I was appointed the resident consultant psychiatrist to the islands in 1989, after which time a consultative process between the Ministry of Health, Senior Management of the George Town Hospital and myself allowed the development and establishment of a comprehensive community-based mental health service delivery system (MHSDS), specifically designed to suit the needs of the Cayman Islands. The framework for the service is outlined, and the concerns and objectives of the MHSDS are discussed, along with short-term and long-term goals. (AU)
Assuntos
Humanos , Serviços Comunitários de Saúde Mental/tendências , Atenção à Saúde/tendências , Região do Caribe , Assistência ao Paciente/tendências , Serviços de Saúde Comunitária/organização & administraçãoRESUMO
This paper reviews the development of mental health services in the Cayman Islands throughout a twelve-year period (1989 to 2001). I was appointed the resident consultant psychiatrist to the islands in 1989, after which time a consultative process between the Ministry of Health, Senior Management of the George Town Hospital and myself allowed the development and establishment of a comprehensive community-based mental health service delivery system (MHSDS), specifically designed to suit the needs of the Cayman Islands. The components of the MHSDS and their evolution in the absence of adequate facilities are reported. The framework for the service is outlined, and the concerns and objectives of the MHSDS are discussed, along with short-term and long-term goals.
Assuntos
Humanos , Atenção à Saúde/tendências , Serviços Comunitários de Saúde Mental/tendências , Assistência ao Paciente/tendências , Índias Ocidentais , Serviços Comunitários de Saúde Mental , Serviços Comunitários de Saúde Mental/organização & administraçãoRESUMO
This paper reviews the development of mental health services in the Cayman Islands throughout a twelve-year period (1989 to 2001). I was appointed the resident consultant psychiatrist to the islands in 1989, after which time a consultative process between the Ministry of Health, Senior Management of the George Town Hospital and myself allowed the development and establishment of a comprehensive community-based mental health service delivery system (MHSDS), specifically designed to suit the needs of the Cayman Islands. The components of the MHSDS and their evolution in the absence of adequate facilities are reported. The framework for the service is outlined, and the concerns and objectives of the MHSDS are discussed, along with short-term and long-term goals.
Assuntos
Serviços Comunitários de Saúde Mental/tendências , Atenção à Saúde/tendências , Serviços Comunitários de Saúde Mental/organização & administração , Humanos , Assistência ao Paciente/tendências , Índias Ocidentais , Recursos HumanosRESUMO
Se describen tres etapas históricas del desarrollo de la salud mental en Chile: crecimiento (1952-1973); involución (1974-1989), y consolidación (1990 a la fecha). La docencia de pregrado en medicina destina en 5º año sólo el 10 por ciento del horario de psiquiatría a salud mental. La formación de posttítulo, en psiquiatría durante tres años, asigna 93 por ciento del tiempo a ciencias clínicas, y 7 por ciento a salud mental. El magister en salud pública con mención en salud mental, en postgrado, mejora la situación, dedicando, en los dos años, 25 por ciento del horario a salud pública general y 75 por ciento a salud mental, incluida la tesis. En nueve escuelas de psicología del Mercosur, sólo cinco incluyen salud mental en pregrado, con menos del 5 por ciento de la carga horaria total. Se discute la repercusión de esta falencia formativa, de pregrado y posttítulo, en la implementación del plan nacional de salud mental, del Ministerio de Salud. Se mencionan brevemente los principales centros de formación de personal de Salud Mental en Chile. La formación de personal no profesional en Salud Mental, técnicos y monitores, la desarrollan, principalmente, la Pastoral de Alcoholismo y Drogadicción, de la Iglesia Católica, la Unión de Rehabilitadores de Alcohólicos de Chile y las asociaciones de familiares de pacientes mentales
Assuntos
Humanos , Mão de Obra em Saúde/tendências , Saúde Mental , Serviços de Saúde Mental , Serviços Comunitários de Saúde Mental/tendências , Educação de Pós-Graduação em Medicina/tendências , Educação de Graduação em Medicina/tendências , Educação em Saúde/tendências , Pessoal de Saúde/educação , Associações de Ajuda a Doentes Mentais/organização & administração , Psiquiatria/educação , Saúde Pública/educaçãoRESUMO
The consultative study is one model of academic involvement in public mental health services. However, the effects of consultation and how it acts as a catalyst for change have been poorly documented. The authors describe a consultative study in which a team from a academic training center examined the system of mental health and related human services for children and adolescents in a semirural county in western Pennsylvania. They also present results of a six-year follow-up survey assessing the study's effects. Improvement in the system of care during the follow-up period included creation and maintenance of a children's unit and a partial hospital program for adolescents at the country's community mental health center. The consultative study and the follow-up survey were instrumental in establishing a comprehensive range of services, including intensive case management for severely disturbed youngsters and a home-based mental health services program.