Conhecimento em saúde mental, atribuição e percepção de estigma entre profissionais da atenção básica

Abstract

This thesis aims to analyze mental health knowledge, attribution of stigma and the perception of stigma among professionals of Primary Health Care (PHC) in Rio Grande do Sul. It is a research of quantitative and qualitative designs, divided into four studies. Study 1 describes the process of adapting and validating a mental health knowledge instrument (Mental Health Knowledge Schedule - MAKS) for the Brazilian context. The MAKS-BR version was administered through an online questionnaire, with a sample of 273 people. The reliability value for items 1-6 calculated by Cronbach's alpha was 0.61, which is considered acceptable. The results show that the MAKS-BR instrument maintained adequate parameters of validity and reliability. Study 2, of a quantitative character, aimed to investigate the association between the presence of stigma related to people with mental health problems among PC professionals, in relation to sociodemographic characteristics, contact variables and participation in mental health actions. Participants were 289 professionals. Instruments: a) Sociodemographic questionnaire; b) Questionnaire on Knowledge in Mental Health (MAKS-BR); c) Attribuition Questionnaire (AQ-26B); d) Mental health items from the National Program for Improving Access and Quality in Primary Care (PMAQ-AB). The results show that the greater knowledge on mental health, the lower is the stigma attribution score. The variables that most influence knowledge and attribution of stigma are contact with someone with a mental health problem, having training/qualification in mental health and carrying out mental health activities. The third article analyzed how the stigma related to people with mental health problems is present in the discourse of professionals and its possible reflexes in the Primary Care work context. Participantes were ten professionals. For data collection, semi-structured interviews were used, and for data analysis, thematic analysis was used. The stigma related to alcohol and drug users appears more explicitly in the professionals' statements, as well as their responsibility for their health condition. Professionals identify mental health training as a strategy for reducing stigma related to mental health problems, as well as matrix support and multi-professional teamwork. The fourth article consists of a systematic review of the practices developed by psychology professionals in the context of the NASF, with the objective of analyzing both interdisciplinary and specific actions by psychologists. The results were organized according to the actions that involved psychologists, with individual care being the main activity attributed to them. Among the interdisciplinary actions, the following stand out: sensitizing the team to matrix support and to welcoming and humanizing care. The results point to the importance of mental health practices in Primary Care, of the training and qualification of teams to reduce stigma.