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      Apoio matricial: um caminho para a integração saúde mental e atenção primária Translated title: Matrix support: a way to mental health and primary health care integration

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          Abstract

          O ensaio aborda a integração da saúde mental na Atenção Primária à Saúde por meio do apoio matricial. Traz os diferentes aspectos da inserção da saúde mental na atenção primária e os fatores que atuam como barreiras ao processo. Discute os achados de pesquisas nacionais e internacionais sobre a temática e os elementos comuns à descentralização em saúde mental. Os resultados permitem inferir que a supervisão e o suporte de especialistas, a sistematicidade dos encontros, a longitudinalidade, a capacitação de profissionais generalistas e especialistas, os cuidados coordenados em rede e os recursos invisíveis desempenham um papel central para a integração saúde mental e atenção primária.

          Translated abstract

          This essay tackles the integration of mental health in Primary Health Care through the matrix support. It brings the different aspects of integration of mental health insertion into primary care and the factors that act as barriers to the process. It discusses the findings of national and international researches about the theme and the common elements to decentralization in mental health. The results allow us to infer that the supervision and the support of experts, the systematic nature of the meetings, the longitudinality, the enablement of both generalist and expert professionals, the coordinated cares in network and the invisible resources perform a central role for the integration of mental health and primary care.

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            Building capacity in mental health interventions in low resource countries: an apprenticeship model for training local providers

            Background Recent global mental health research suggests that mental health interventions can be adapted for use across cultures and in low resource environments. As evidence for the feasibility and effectiveness of certain specific interventions begins to accumulate, guidelines are needed for how to train, supervise, and ideally sustain mental health treatment delivery by local providers in low- and middle-income countries (LMIC). Model and case presentations This paper presents an apprenticeship model for lay counselor training and supervision in mental health treatments in LMIC, developed and used by the authors in a range of mental health intervention studies conducted over the last decade in various low-resource settings. We describe the elements of this approach, the underlying logic, and provide examples drawn from our experiences working in 12 countries, with over 100 lay counselors. Evaluation We review the challenges experienced with this model, and propose some possible solutions. Discussion We describe and discuss how this model is consistent with, and draws on, the broader dissemination and implementation (DI) literature. Conclusion In our experience, the apprenticeship model provides a useful framework for implementation of mental health interventions in LMIC. Our goal in this paper is to provide sufficient details about the apprenticeship model to guide other training efforts in mental health interventions.
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              O apoio matricial em Unidades de Saúde da Família: experimentando inovações em saúde mental

              A Reforma Psiquiátrica busca superar as intervenções tradicionalmente hospitalocêntricas e medicalizantes em relação à "loucura". Para isso, visa implantar estratégias de cuidado territoriais e integrais, ancorados em novos saberes e valores culturais. Nessa perspectiva, o Apoio Matricial surge como proposta para articular os cuidados em saúde mental à Atenção Básica. Este trabalho objetiva discutir a perspectiva de técnicos de Unidades de Saúde da Família (USF) do município de Natal, RN, acerca dessa proposta. Foram realizadas entrevistas com oito técnicos da USF do Distrito Sanitário Leste da cidade. A partir dos resultados observamos que não há clareza acerca da proposta de Apoio Matricial (AM) e há uma forte demanda cotidiana de saúde mental não acolhida, pois os entrevistados não se sentem capacitados para tal e indicam a necessidade de apoio e instrumentalização nesse campo. Além disso, as possibilidades de referenciamento são pequenas em função da precariedade da rede de serviços substitutivos e destes com a rede do Sistema Único de Saúde (SUS) como um todo. O trabalho compartilhado com o Centro de Atenção Psicossocial (CAPS) é ainda uma promessa.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Journal
                sdeb
                Saúde em Debate
                Saúde debate
                Centro Brasileiro de Estudos de Saúde (Rio de Janeiro )
                2358-2898
                September 2014
                : 38
                : 102
                : 582-592
                Affiliations
                [1 ] Universidade Luterana do Brasil Brazil
                [2 ] Universidade Luterana do Brasil Brazil
                Article
                S0103-11042014000300582
                10.5935/0103-1104.20140054
                0ed982df-2fa4-4855-b4eb-d7f83553305a

                http://creativecommons.org/licenses/by/4.0/

                History
                Product

                SciELO Brazil

                Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=0103-1104&lng=en
                Categories
                HEALTH CARE SCIENCES & SERVICES
                HEALTH POLICY & SERVICES

                Health & Social care,Public health
                Mental health,Primary Health Care,Matrix Support,Shared Care,Health management,Saúde mental,Atenção Primária à Saúde,Apoio matricial,Cuidado compartilhado,Gestão em saúde

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