Acesso aos serviços de saúde mental na Amazônia brasileira: uma revisão de escopo

Abstract

Introduction: In Brazil, health policies state that health care and accessibility to actions and services are related to the right to health in a comprehensive way through universal and equitable access. For some years now, guidelines have been the basis for psychiatric reform in Brazil, abandoning the asylum model and consolidating the community care model in the SUS, which is more humane, active, accessible, of quality, and with social control. Daily, the SUS presents vulnerabilities at all levels of health care, especially in the North and Northeast regions, and exclusively in the Amazon, due to the challenge of the complexity of this territory. Objective: To map the production of knowledge about access to mental health services by the population of the Brazilian Amazon. Methods: This is a scoping review, which adopted as a theoretical framework the approach proposed by the Joanna Briggs-JBI Institute for scoping reviews. The search was carried out in the Web of Science, PubMed, Scielo, and Virtual Health Library databases, and the terms used were Amazonian population, accessibility, mental illness, and their respective counterparts in Portuguese and Spanish. The searches in the databases generated a total of 149 results, 26 of which were considered eligible because they dealt with the theme of this review. Results: The analysis of the collected material enabled knowledge about access to mental health in the Amazon. Thus, the reading and interpretation of the data made it possible to organize three categories: 1) Factors associated with the search for mental health services by the Brazilian Amazonian population; 2) Mental health services used by the population of the Brazilian Amazon and 3) Mental disorders most evidenced and the form of resolution by the psychosocial care network. Conclusion: It is concluded that the unbridled exploitation of the Brazilian Amazon, without adequate supervision of those responsible, causes damage in all aspects to the traditional population, especially regarding mental health, with the population presenting mental disorders, with a high prevalence of anxiety, depression and schizophrenia in women, with inadequate assistance to the Amazonian population at all levels of health care. The information points to the difficulties encountered in the context and in management. However, it should be noted that public policies punctuate mental health services and their implementation throughout the Brazilian territory, but they are still not very expressive in this region, which also expresses the neglect of the issue of mental health.