Mental health in primary care: possibilities for a practice focused on the expansion and integrality of mental health

Abstract

This study investigates practices in mental health at primary healthcare by a Family Health Strategy (ESF- Estratégia Saúde da Família) team, in order to prompt reflection on the subject. The survey was conducted through semi-structured and individual interviews with ten staff members of the ESF team, aged between 20 and 50 years, all women. Healthcare practices were described as "differential treatment", "groups and home visits", "accountability of the family", and "over-emphasis on medical interventions". The results indicate that the interviewees' concepts reflect practices that are heavily geared towards mental health as mental disease/disorder, which is the main focus of the team practices; these only rarely focus on health promotion and preventive mental care. Thus, it was seen that the principles of comprehensiveness and a wider clinical practice are still not present in the ESF team studied. For the implementation of a comprehensive and expanded healthcare practice, the ESF teams need to be willing to assume a pivotal role in structuring the healthcare network, building new concepts and practices that are governed by the needs and subjectivities of the users who seek the service, and striving to implement, within the network of services, practices aimed at promotion and prevention in mental healthcare.