Children and adolescents mental health: the care in the small sized-cities

Abstract This research presents the care strategies in Child and Adolescent Mental Health (SMIJ) in the municipality of Guamiranga, located in the south-central region of the state of Paraná. We seek to understand which strategies are used, based on the experiences of Community Health Agents (CHA), to identify and monitor children who have demands for mental health care. This research was divided into three stages: accompanying home visits, a focal group with CHAs and an analysis and data systematization utilizing Institucional Analysis. We understand that in order to produce this complex care network for CAMHC, it´s necessary to overcome the logic of personification, especialization and medicalization in the hopes that this care model for the CAMHC becomes a part of the political agenda of the city. The care needs to be based on the logic of co-responsibility and intersectoriality so that it´s not set on education as the place responsible for these issues.【摘要】本研究针对坐落于巴西巴拉那州中南部的瓜米兰加市的儿童与青少年心理健康（Child and Adolescent Mental Health, SMIJ）照护策略展开探讨。本研究旨在依托社区健康专员（Community Health Agents, CHA）的实践经验，明确当地用于识别并监护存在心理健康照护需求儿童的各类策略。本研究分为三个实施阶段：入户随访、面向社区健康专员的焦点小组座谈，以及采用制度分析（Institutional Analysis）开展的数据分析与系统化梳理工作。我们认为，若要构建儿童与青少年心理健康照护（CAMHC）的复杂照护网络，必须破除人格化、专业化与医疗化的固有逻辑，以期将儿童与青少年心理健康照护模式纳入该市的政治议事日程。该照护服务需基于共同责任与跨部门协作的逻辑开展，切不可将教育机构作为承担此类职责的唯一责任主体。