The challenges of network organization in specialized psychosocial care: the case of Recife

Abstract

The objective of this study was to analyze the specialized mental health care of the city of Recife and its care regulation process. This is a descriptive and exploratory study with a qualitative approach, conducted through document analysis, observation, semi-structured interviews and field diary. The research subjects were managers and health professionals from the Psychosocial Care Centers (CAPS) of Recife. We worked with thematic content analysis, using the meaning condensation technique. Type III CAPS coverage is insufficient and there are communication weaknesses between the network components. In addition, mental health outpatient clinics work in complementarity with the asylum / hospital-centric model, dissonant of the Brazilian Psychiatric Reform. Care regulation is incipient in mental health and focused on the specialized appointment booking flow, favoring outpatient care without conversation devices among professionals. Therefore, mental health care with the logistical support of care regulation is still a challenge for municipal management. Finally, it is noteworthy that the weaknesses in the organization of the network in the city of Recife may still be aggravated by the perspective of remanicomialization made explicit by the anti-reform agenda that since 2017 has been instituting changes in the National Mental Health Policy in Brazil.