Avaliação da estrutura e processo dos Centros de Atenção Psicossocial I - da região de saúde Ilha do Bananal, Tocantins

Abstract

The Psychosocial Care Centers (CAPS) are open, community health services that provide daily clinical follow-up to people with severe and persistent mental disorders and assist in social reinsertion through therapeutic practices involving, among other activities, work and play. The role of CAPS is to promote the development of users' autonomy and citizenship, reintegrating them into social life and family life. The general objective of this study was to evaluate the structure and process of CAPS I, from the perspective of the professionals of these centers. The specific objectives were: evaluation of the organizational structure of the CAPS regarding physical dimensions, human resources and materials; evaluation of the work process in the CAPS and elaboration of a report for the municipal health managers with proposals of improvements in the structure and process according to the deficiencies found. The CAPS of the "Bananal Island" Health Region were studied, being the CAPS I (in the Formoso do Araguaia and Gurupi cities) that attend patients with diverse mental disorders. In the theoretical framework we sought to understand aspects related to the history of public politic on mental health; the CAPS in the context of mental health services; health and quality assessment in CAPS. The methodology was quantitative and qualitative. The data collection was done through a questionnaire with 102 guiding questions. It was observed in the "process" dimension, in relation to working conditions, 50% of the participants reported that they improved little, 25% reported that working conditions worsened since they entered employment and the other 25% reported that they have not changed since they entered in the job. Regarding the patient's individualized contact, 100% answered that a more adequate frequency of individual contact between the team members and the patient would be required at least once a day. Lack of networking got the worst results, ie, patients require other services that CAPS does not provide. Lack of community support, lack of support from the secretariat in relation to CAPS care was also reported. Regarding the dimension of "structure" in what refers to participation in the evaluation process, 50% responded indifferently, 25% responded very satisfied, 25% responded satisfied. Regarding the opinions given in the service, 50% answered that they are satisfied, 25% dissatisfied and 25% very dissatisfied. In relation to the climate in the workplace, 100% said they are satisfied. Regarding the structure dimension, as an unsatisfactory result, we observed the overload, work controlled by superiors, lack of incentives, unsatisfactory wages. It is suggested that municipal managers increase the participation of management in meetings for health, physical and mental care, with ongoing training to better prepare them. Support regarding care and enhancement of professional CAPS I. In this sense we note that the evaluation of mental health services becomes essential for the analysis of the effectiveness of psychosocial practices, service dynamics, implementation and commitment to the proposal of psychiatric reform.