Perfis e práticas dos profissionais de saúde mental em dois hospitais psiquiátricos de grande porte

In the Brazilian network of psychosocial care, health professionals are important actors in the process of transformation of mental health public policies among various services. In the reality of psychiatric hospitals, one should understand the need to expand the debate about the current context of practices developed. This study aimed at analyzing the process of psychiatric reform and the mental health policy in the State of Rio Grande do Norte (RN) from the profiles and practices of higher-level professionals in two psychiatric hospitals. This is a cross-sectional and descriptive research, with quantitative and qualitative data, conducted in two psychiatric hospitals of RN. The universe of the target population was 95 professionals, taking into account the margin of error of 8%, non-response rate and the inclusion criteria: holding effective link with the institution by means of approval in public examination for, at least, six months, being state or municipal servant; having a minimum weekly workload of 20 hours in service; participating in care and/or activities with patients and families in a direct way. The final sample consisted of 60 professionals. The tool for data collection was a questionnaire with closed and semi-open questions about socioeconomic profile, and mental health policies, practices and training. Quantitative data were tabulated in the statistical software SPSS, and simple and bivariate statistics, chi-square type, was used for analysis by adopting the significance level with the value p<0,05. In order to analyze data, the content analysis of Bardin was used. The qualitative findings obtained with the semi-open questions in Analyse Lexicale par Context d'un Ensemble de Segments de Texte (ALCESTE) were grouped into four thematic axes: Professional action in mental health; Mental health training; Scenarios of psychiatric reform and psychiatric hospitals; Mental health policies and practices: challenges for professionals in hospitals. The profile of professionals has revealed the majority of women (89,7%), nurses (36,7%), aged 50-59 years (42,9%), weekly workload of 40 hours (52,4% ), time of completion of graduation from six to 15 years (57%), and 21,4% reported to have specialization in mental health. Regarding the practices developed in individual care, it was found an association between those who do not build or partially conducts the therapeutic project and those who conduct care related to observation and annotation. In family care, it was obtained care consultation during crisis; and, in group care, recreational activities. In the analysis of thematic axes, it was noted that, despite changes identified in the profiles and practices of higher-level professionals in care services for mental health, with the implementation of new public policies for this field, the findings indicate the confluence of asymmetries and divergences in the actions of the teams in psychiatric hospitals, difficulties in managing services, frequent readmissions, reduced quantitative of available services and equipment, high demand of users, disarticulation of the network of psychosocial care, and the very shortage of skilled human resources to compose these services. Accordingly, the evidenced scenarios partially outline the current political and ideological mismatch of the national process of psychiatric reform that denies the role of care actions conducted within hospitals, although it has not gone far enough with the creation of new services that justify the total extinction of this institutionNa rede de atenção psicossocial brasileira, os profissionais de saúde são atores importantes no processo de transformação das políticas públicas em saúde mental entre os diversos serviços. Na realidade do hospital psiquiátrico, entende-se a necessidade de ampliar o debate em torno do atual contexto de práticas desenvolvidas. O estudo objetivou analisar o processo de reforma psiquiátrica e a política de saúde mental no Estado do Rio Grande do Norte (RN) a partir dos perfis e práticas dos profissionais de nível superior em dois hospitais psiquiátricos. Pesquisa transversal e descritiva, com dados quantitativos e qualitativos, realizada em dois hospitais psiquiátricos do RN. O universo da população alvo foi de 95 profissionais, considerando-se a margem de erro de 8%, taxa de não resposta e os critérios de inclusão: possuir vínculo efetivo com a instituição por meio de aprovação em concurso público por, no mínimo, seis meses, sendo servidor estadual ou municipal; possuir uma carga horária semanal mínima de 20 horas no serviço; participar diretamente de atendimento e/ou atividades com pacientes e familiares. A amostra final foi de 60 profissionais. Utilizou-se como instrumento de coleta de dados um questionário de perguntas fechadas e semiabertas sobre o perfil socioeconômico, as políticas, as práticas e a formação em saúde mental. Tabularam-se os dados quantitativos no software estatístico SPSS e para análise utilizou-se estatística simples e bivariada, do tipo qui-quadrado, adotando-se o nível de significância valor p