Social determinants for health (mental): evaluating a non-governmental experience from the perspective of actors involved

Revista Brasileira de Epidemiologia

Melo, Anna Karynne da Silva³  Bosi, Maria Lucia Magalhães¹  Godoy, Maria Gabriela Curubeto²  Carvalho, Liliane Brandão³  Ximenes, Veronica Morais¹ 

[1] Universidade Federal do Ceará, Fortaleza, Brazil;Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil;Universidade de Fortaleza, Fortaleza, Brazil

关键词: Social determinants of health;    Health;    Desintitutionalization;    Care;    Health professionals;    Qualitative research;   

DOI  :  10.1590/1809-4503201400060011

学科分类：过敏症与临床免疫学

来源: SciELO

【 摘 要 】

INTRODUCTION: The Brazilian Psychiatric Reform, an ongoing process, and its developments involve the construction of new ways of seeing the subject in illness, establishing the mental health field in a new way of understanding the social determinants that reflect in the deinstitutionalization and social inclusion. OBJECTIVE: This study, multidimensional analysis of the relationship between social determinants and deinstitutionalization in mental health focusing on a community movement in Northeast Brazil, whose proposed work is subjective and psychosocial dimensions, aims to explore and analyze how the experiences in course of the Movement highlights the importance of social determinants, the perspective of professionals. METHODS: The methodological approach outlined in the qualitative approach in the form of case studies, employing techniques such as interviews and focus groups. The categorization of analytical information was built from the relationship established between a model based on the constituent dimensions of the psychiatric reform, covering different planes, namely epistemological, healthcare, legal and socio-political, and social determinants of health - living conditions, and work environment, community networks and support, economic, cultural and environmental behaviors and lifestyles. RESULTS: The results show emphasis on the social subject, making the processing and knowledge of professionals, adding new ways to produce health; dialogue with multiple stakeholders, building autonomy, participative management, concern for professionalization; reorganizing the work process; appreciation of the everyday activities that weave and; invention of a new social site, among other elements in close interface with the determinants of health. CONCLUSION: These elements indicate that care practices woven into the daily life of the Movement involve the disassembling the traditional model of mental health care, stimulating new forms of citizenship, thus contributing to the institutionalization and promoting equality of income, social cohesion and participation policy for the promotion and protection of health.

【 授权许可】

Unknown