Resumo

COSTA, Annette; SILVEIRA, Marília; VIANNA, Paula  e  SILVA-KURIMOTO, Teresa. Desafios da Atenção Psicossocial na Rede de Cuidados do Sistema Único de Saúde do Brasil. Revista Portuguesa de Enfermagem de Saúde Mental [online]. 2012, n.7, pp.46-53. ISSN 1647-2160.

This study aims at describing the elements that constitute challenges to psychosocial rehabilitation in the health care system. It is a non-systematic literature review in which articles on the challenges to psychosocial rehabilitation where analysed. This reflective article starts at the Brazilian Psychiatric Reform that brought about substantial changes in mental health care and allowed the reversal of the hospital-centric model and the creation of new modes of care. In this scenario, psychosocial rehabilitation of patients in psychological distress in the context of the health care system comprises a set of challenges, including the articulation between alternative services and primary care, and between caregiving performance and sheltering. The complexity of mental health care requires knowledge and competencies that hitherto were not among primary health care teams repertoire. The concept of sheltering as a device, a strategy, an act, and a right is central to the work process of primary care teams and it is fundamental when considering psychosocial care. Although the goal is the reversal of mental health care models if we are not careful a re-enactment of old practices in a new environment is bound to happen: a new kind of institution without walls is going to be created, but retaining segregation and exclusion as its main values. Psychosocial Care in the health care system is still incipient and it wants individual, social and institutional changes. It is a political challenge that requires constant commitment for the construction of new ways to deal with psychic suffering.

Palavras-chave : Mental Health Services; Primary health care; mental health assistance; user embracement; Community mental health services.

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