Produção de sentidos e práticas de cuidados em saúde mental em comunidades remanescentes quilombolas do Vale do Guaporé, RO

Abstract

This study aims understanding the meanings produced during the everyday lives of the remaining communities of the Guaraporé Valley, in the state of Rondônia, related to health/ mental illness. Furthermore, we investigate care practices of mental health performed by members of these communities and also by the health team that provides care to these quilombola communities. The study was organized in two sections: a theoretical and an empirical. In the theoretical section, we present a systematic review of the literature (Study I), which had as objective to identify studies on mental health developed with quilombola communities and if these studies consider social determinants of health to understand the health and illness process of these populations. The results highlighted social and economic indicators as factors associated to the health and mental health conditions of the remaining quilombola. The empirical section was composed by two studies of qualitative, transversal and exploratory approach. Information was collected through open interviews, conversation circles, systematic observations and field diary, and later analyzed according to the Discourse Analysis technique, influenced by the perspective of Social Constructionism, especially by the Discursive Psychology. The second Study, which composes this section, was performed with six health professionals, and had as objective to describe the meanings produced by them that revealed inequality and social exclusion in the assistance to health in the three quilombola communities of the Guaporé Valley. The discourses presented through the speeches allowed the identification of four interpretative repertoires, namely 1) The social construction of the remaining quilombola from the difference: cordiality, delay and lack of interest; 2) Obstacles in attention: theoretical/practical distancing and (im)mobilities; 3) Mental health problems in the community; and 4) Social, cultural and symbolic aspects as mental health care practices by the community. The third Study had as objective to understand how the remaining quilombola of two communities in the Guaporé Valley produce meanings on mental health. Participated in this study 18 quilombola of both genders. Through the theoretical-analytical resource of the participants discursive practices, it can be noted that, in these communities, the social construction of the mental health is kept in an own recognition concept as well as how to deal with these pathologies. In addition, the use of alternative methods in mental health care, such as natural herbs teas and religious practices with prayers and blessings are common in the daily lives of the communities. For most of the participants, the consumption of alcoholic drinks is understood as the custom and tradition of the community. The results also suggest the need to make public policies feasible to improve community access infrastructure, as well as the implementation of training and continuing education programs for health professionals of the black population.