Macrostructural processes and their impact on the interprofessional proposal in mental health: a study in a city in the state of São Paulo, Brazil
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University of São Paulo, Brazil
Publication date: 2023-04-27
Popul. Med. 2023;5(Supplement):A917
Background and Objective: interprofessionality has been identified as a way to achieve integrality in the Brazilian unified health system (sus), promoting specialties integration and complementarity of care in health teams, with special qualification in mental health and strengthening service’s governance. However, its operationalization is threatened by macrostructural processes. Thus, the objective of this study was to analyze the influence of these processes in the implementation of practices aimed at interprofessionality’s exercise, investigating its potentialities and challenges as a strategy for promoting integrality in health. Methods: This study derives from qualitative research, with the perspective of hermeneutic-dialectic. Data was obtained by two individual interviews, with mental health and primary care coordinators, and two focus groups, one with six professionals from a psychosocial care center (caps) and the other with three professionals from the family health support center (NASF) in a municipality in the state of São Paulo. Data analysis was performed using thematic analysis. Results: Data observed lack of financial, structural and human resources. This influences the team work process, making it difficult to carry out reflective practices and the possibility of integrated teamwork practice. The policies fragility that guarantee these practices feasibility and the management role on planning and evaluating strategies aimed at an integrated practice were also observed. Finally, the health crisis caused by the covid-19 pandemic exacerbated the difficulties previously faced, with the aggravation of population increased demand. Conclusions: Results reinforce macrostructural aspects relevance in policies implementation in health teams routine, indicating that policies fragility, lack of resources and management planning impasses make it difficult to implement the integrality proposal. It is also concluded that the effects of the covid-19 pandemic exacerbated problems that were already present.