FORMAS SOCIAIS DE ATUAÇÃO DO ENFERMEIRO NO CUIDADO A SITUAÇÕES DE CRISE EM SAÚDE MENTAL

Abstract

Introduction: The mental health crisis is a social product, the result of the individual's interaction with their current and historical environment, a moment of conflict that requires transformation. The nurse plays a fundamental role in these situations, especially when acting from a psychosocial perspective. From this perspective, it is an essential social subject for experience and support in crisis situations. Objective: To analyze the social forms of mental health action in crisis situations based on the verbal reports of Primary Health Care nurses. Method: Descriptive-exploratory study, with a qualitative approach, supported by the theoretical-interpretive references of behavior analysis and of historical-dialectical materialism. Data were collected through a semi-structured interview with twelve Primary Health Care nurses and analyzed using the deductive technique proposed by the Theoretical Domains Framework, the methodological framework adopted. Results: The data analyzed allowed the elaboration of three themes: “Nurse knowledge and performance”, “Material, social and institutional resources” and “Beliefs, goals and emotions” which highlight a predominantly asylum-based social form of action, taking into account the political and economic suffocation of the necessary conditions for implementing psychosocial care. In this way, action has been guided by the “extension” of biomedical-psychiatric work, with appreciation of “clinical-technical-bureaucratic” activities, strengthened by a situation of scarce resources and insufficient training. This situation falls into the focus on activities to identify and reduce signs/symptoms, classification, medicalization, referral of demands. The incipient communication between the different levels of the Psychosocial Care Network stands out. Final considerations and implications for practice: The study enabled the development of a concrete and theoretical-critical analysis of the material reality of nurses regarding their performance in mental health crisis situations, explaining a predominantly asylum social form, with practices that erase the meanings of crisis situations for the individual. Furthermore, nurses have been experiencing a situation of precariousness and limited resources, a situation that for them is correlated with the recurrence of crisis situations and worsening of mental health problems. Furthermore, the need for political organization by nursing was highlighted, with social mobilization and fight against the asylum care model, valorization of the profession and greater investment in the network and in a permanent education strategy, with a view to consolidating the perspective of Psychiatric Reform.