Community Health Agents contributions to set up the profile of Primary Care Services users with mental health demands

ABSTRACT Background Primary Care Services is part of the Brazilian Psychosocial Care Network (PCN) and is expected to play a fundamental role in the identification of cases, monitoring and promotion of mental health, to which Community Health Agents (CHA) can contribute. Objective Analyze the mental health situation of the municipality of Itabuna - BA, compare information provided by CHAs and the Health Information System for Primary Care (SISAB). Method This was an exploratory, descriptive, documentary research that retrieved information from the SISAB and from Mental Health Coordination registry files, completed by CHAs. Results The participation of CHAs increased by more than six times the number of people with mental disorders identified, but the number of users of alcohol and other drugs was lower than that registered in SISAB. Conclusion There was evidence of PCN disarticulation and a model of biological and hospital-centered care. The sources of information complemented each other, evidencing underreport of mental health cases and good potential for CHAs assistance in the active search of users with mental disorders, but not of drug users. Mental health problems were related to aspects of socioeconomic vulnerability, indicating the need for intersectoral articulation to provide comprehensive health care.

摘要
背景 基层医疗服务隶属于巴西社会心理护理网络（Psychosocial Care Network, PCN），其在病例识别、心理健康监测与促进工作中承担核心职能，而社区健康专员（Community Health Agents, CHA）可为此提供重要助力。
目的 分析巴伊亚州伊塔布纳市的心理健康现状，对比社区健康专员上报信息与基层医疗健康信息系统（Health Information System for Primary Care, SISAB）所收录的数据。
方法 本研究为探索性描述性文献研究，数据来源于SISAB及社区健康专员填报完成的心理健康协调机构登记档案。
结果 社区健康专员参与后，精神障碍确诊病例的上报数量增长逾六倍，但酒精及其他药物依赖使用者的上报人数却低于SISAB的登记数据。
结论 研究证实巴西社会心理护理网络存在协同脱节问题，当前护理模式偏向生物学导向与医院中心化。两类信息源可互为补充，这表明心理健康病例存在漏报情况，社区健康专员在主动寻访精神障碍患者方面具备良好协助潜力，但在药物依赖患者的主动寻访工作中仍存在不足。心理健康问题与社会经济脆弱性因素显著相关，提示需推进跨部门协同以提供整合式医疗服务。