Análise de Implantação da Rede de Atenção Psicossocial em Salvador.

Abstract

The Brazilian mental health policy is the result of struggles and mobilization of human rights, at a time of the country's redemocratization, where there were several movements and legislation to redirect the care model in this area. In 2011 the ordinance was published establishing the Psychosocial Care Network (RAPS) for people with suffering or mental disorder, expanding the access and integrating the points of care in mental health care. Studies in the country reveal a demand for mental health organized from Primary Care, with support from other services, but also the difficulty of these professionals in dealing with mental health needs, as well as little articulation with the updated Psychosocial Care Centers (CAPS) resulting in a network still centered only on CAPS and psychiatric hospitals, with increased demand for psychiatric urgency/emergency. This reality is seen in Salvador, which has gaps in studies evaluated on this theme and which covers the entire city. This work aims to analyze the implementation of RAPS in Salvador, from 2006 to 2020. It is an evaluation study with a qualitative approach. For the theoretical foundation Carlos Matus' theory of social game was used in order to bring elements of the context of network deployment. A logical model designed as a RAPS should be operationalized considering its objectives, activities at each point of care and intermediate and final results was elaborated. Data were collected through official documents, as well as interviews and online focus groups with key informants. All material was processed and analyzed in the light of the logical model and social game theory. To measure the degree of implementation of the network, a matrix was created with analysis dimensions and indicators submitted to the consensus technique. The results revealed that the prize disputed in the social game is the RAPS health care model. This network showed an incipient degree of implementation far from achieving comprehensive care for users. The macro organizational, communication and science games that have greater influence on nodes due to implementation, considering that for players to have the desire for the game and the ability to play, they need an adequate work structure, knowledge / training, as well as relate to other players. It is necessary that the implementation of RAPS is a municipal government policy and that there are planning actions to overcome the main knots, as well as the monitoring of these actions through the information systems for the necessary basic adjustments.