Detecting mental health disorders in primary health care is a way to early treat problems such as depression, anxiety and alcohol and other substance abuse.
The WHO (World Health Organization) recommends that public health systems implement community-based actions and services to train professionals who work at this point.
As a partner in this action, Hospital Israelita Albert Einstein created the “Mental Health in Primary Health Care (APS)”, an initiative carried out within the scope of Proadi-SUS (Program to Support Institutional Development of the Unified Health System), in partnership with with the Ministry of Health and Conass (National Council of Health Secretaries).
“Mental health care in primary care is possible and resolute. So with this program we hope to increase resoluteness, increase case detection and expand patients’ access to treatments”, explains nurse Ana Alice Freire de Sousa, coordinator Mental Health technique at PHC and Projects and New Services at Einstein.
“With proper listening and attention, every medical consultation can be a mental health consultation. During routine care for a pregnant woman or an elderly person, for example, the professional can identify whether there is suffering there”, he observes.
The project covers 63 municipalities in three states: Maranhão, Goiás and Rondônia. In addition to revisiting the work processes of PHC services through health care planning, the Einstein team will train around 800 professionals using the Mental Health Gap Action Program (mhGAP) intervention manual, a clinical guide for consultation and ordering of mental health care organized by PAHO (Pan American Health Organization).
Operational stages are carried out, with workshops, planning and monitoring workshops and tutorials aimed at state, regional and municipal technical teams and PHC professionals with a focus on organizing the mental health care line. Concomitantly with these activities, 12 groups are planned for training manual multipliers, who will be able to train all teams in the region.
Sousa says that the forecast is that all professionals considered multipliers — those around 800 who are being trained — will graduate this year and that, still in the second half of 2022, they will begin to pass their knowledge on to other primary health care workers in the regions where they operate. The program is expected to be completed by the end of 2023.
“In the end, we will have a very important number of trained professionals and services prepared for this look”, he emphasizes.
Another point highlighted by Sousa is that, when talking about mental health, disorders such as depression and anxiety are often discussed. The discussion about the abuse of alcohol and other substances ends up being marginalized.
“These are problems that can be managed in primary care when agents are prepared for this approach”, he says.
The mental health of children and adolescents is also neglected. “That’s why we are preparing a material on life skills, with which professionals will be able to propose games and other activities with the youngest in order to be able to dialogue with them”, he says.
“One of our missions, and all our responsibility with SUS, is so that our program is not just a wind, that when the project ends, everything stops. The idea is that we can institutionalize these practices and disseminate them as much as possible. possible”, he says.
​What is Proadi-SUS?
The Support Program for Institutional Development of the Unified Health System was created in 2009 with the purpose of supporting and improving the SUS through human resources training projects, research, evaluation and incorporation of technologies, management and specialized assistance demanded by the Ministry of Health. of health.
Currently, the program brings together six hospitals that are a reference in medical-care quality and management: Hospital Alemão Oswaldo Cruz, BP – A Beneficência Portuguesa de São Paulo, HCor, Hospital Israelita Albert Einstein, Hospital Moinhos de Vento and Hospital SÃrio-Libanês.
Proadi-SUS resources come from the tax immunity of participating hospitals. The projects bring to the population the expertise of these institutions in initiatives that meet the needs of the SUS. Among the main benefits of Proadi-SUS, the reduction of waiting lines, qualification of professionals, research in the interest of public health for the current needs of the Brazilian population, care management supported by artificial intelligence and improved management of public hospitals and philanthropists throughout Brazil.
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