IMPLEMENTATION OF IMPROVEMENTS IN MENTAL HEALTH CARE IN THE FAMILY HEALTH STRATEGY (FHS) OF THE MUNICIPALITY OF RIO BRANCO – ACRE

Abstract

Introduction: The purpose of this study is to implement improvements in mental health care in the Family Health Strategy of the Municipality of Rio Branco, Acre State, Brazil. Primary Health Care has as attributes access, integrality of care, longitudinality and coordination of care, establishing a relationship of bonding between the Family Health team of the territory where the family and community coverage is located, and triggering a process of mental health care, based on a logic centered on the subject and his subjectivity. The problem exposed focuses on the difficulty that the teams present in providing mental health care to people and family members in psychological distress in the territory covered by the Family Health Strategy. Objective: To analyze the improvement actions implemented in mental health care in the Family Health Strategy of the Municipality of Rio Branco/AC. Method: Improvement implementation study with a qualitative approach. The research scenario was the Municipality of Rio Branco/AC, in the context of Primary Health Care in the years 2022 and 2023, using the DMAIC method - Define, Measure, Analyze, Implement and Control for the construction of indicators and implementation of improvements through kaizen workshops held with the professionals participating in the study stages. This study was developed in eight Family Health teams composed of professionals from eight health segments, resulting in a research sample of 32 participants. Results and Discussion: Implementation of improvements in mental health care in the Family Health Strategy, through strategic actions developed by the Family Health teams in the kaizen workshops, with the survey of the possible causes of the problems, to understand and improve the process of monitoring people in psychic suffering in the Family Health Strategy,  as well as the measurement of mental health activities, using the mental health indicators of the Municipal Health Plan of Rio Branco, built by the Key Performance Indicators tool: Percentage of mental health promotion strategies developed in the territory at the UBS; Percentage of activities carried out in a network in comprehensive mental health care for the most vulnerable audiences; Percentage of follow-up of people in psychological distress through (individual consultation, interconsultation or joint consultation) at the UBS; Percentage of group activities developed at the UBS with people in mental suffering who are chronically using benzodiazepines, antidepressants and mood stabilizers; Percentage of mental health care practices carried out by the family health team with the support of multiprofessional teams. The thematic analysis resulted in the elaboration of three themes: Paths, Bonds and Effective Communication, Information and Services and the Process: A New Look. Conclusion: This study presented relevant results for the health area, as it pointed to the need to have mental health indicators in Primary Health Care, to monitor the health actions developed by Family Health teams in mental health care. She also denounced the need for studies on this theme, as the literature points to time gaps related to quality indicators in mental health care in primary care, at the national and municipal levels.