O imaginário coletivo de agentes comunitárias de saúde sobre usuários de saúde mental

Abstract

Community Health Agents (ACSs abbreviation in Portuguese) provide an essential link between health care teams and the community in the context of primary health care, including mental health care. However, the collective imaginary of ACSs about users mental health may hinder the creation of a therapeutic relational field to the extent that refers to a specific group s ensemble of beliefs and images concerning a particular phenomenon or population which, ultimately, supports its behavior. The present study seeks to understand the collective imaginary of a group of ACSs in relation to users of mental health by means of a qualitative method, specifically, the clinical-qualitative method. The subjects considered eligible for participation in this study were ACSs whom, at the time of the study, had worked for the Unit of Primary Attention to Family Health (UAPSF abbreviation in Portuguese) in the municipality of Uberlândia, Minas Gerais, for at least six months. All the ACSs who met with this criteria were invited and accepted to take part in this study; all participants were female. The locus for data collection was a psychoanalytical discussion group in which the author was the moderator. The ACSs participated in four encounters, each of which lasted approximately an hour and twenty minutes. During these encounters, participants discussed themes related to mental health in general as well as professional practice together with the users and the public policies about this subject. The corpus was consisted by the transcripts of the encounters along with graphic production due to the use of the mediating resources chosen for its development. The corpus was subsequently analyzed via the psychoanalytical interpretation as a methodological procedure with the aim to enable the identification of the latent meanings. The interpretation of the corpus led to the captation of two fields of affective-emotional sense. Based on the participants words, these fields were identified as follows: (1) Between the pity and the fear and (2) To be or not to be... medicated . The first field of affective-emotional sense was organized around the belief that the users of mental health are characterized as presenting a certain degree of instability and danger. The second field of affective-emotional sense revealed that participants recognize some possibilities of caution for this population, but emphasize psychotropics as central to such mental health assistance. Additionally, the obtained results were interpreted by recurring to the notion of identification while psychoanalytical conceptual operator because was identified a common denominator between the participants in accordance with her collective imaginary, and the users of mental health. This last one was delimited essentially by a social marginalization in the context of health. Ultimately, the present study provides elements that allow for the understanding of the collective imaginary from an ACSs group in relation to users of mental health. However, the results obtained can not be generalized indiscriminately to the other ACSs or to the other contexts because they demand, by the reader s side, a cautious attention about the possibilities of extension.