Psychosocial Care Center: daily work and articulation with the network in the pandemic

Objective: to analyze the daily work of a Psychosocial Care Center and its articulation with the Psychosocial Care Network in the context of the COVID-19 pandemic. Methods: this is a qualitative study, produced by means of the researcher’s diary and semi-structured interviews with nine health professionals, submitted to thematic-categorical content analysis. Results: the pandemic revealed failures in the management of services, lack of public investment, and the unpreparedness of professionals, intensifying work fragmentation, network disarticulation, non-assistance, and pre-existing asylum practices. Conclusion: the reality of the daily work of psychosocial care services shows that multifaceted actions that consider the complex social process of the psychiatric reform are necessary, especially in the pandemic, seeking the effective institutionalization of the psychosocial care model and the formation of centers of resistance to the established asylum model. Descriptors: Work; Institutional Practice; Mental Health Services; COVID-19. RESUMO Objetivo: analisar o cotidiano do trabalho de um Centro de Atenção Psicossocial e sua articulação com a Rede de Atenção Psicossocial no contexto da pandemia da COVID-19. Métodos: trata-se de um estudo qualitativo, produzido por meio do diário do pesquisador e entrevistas semiestruturadas com nove profissionais de saúde, submetidas à análise de conteúdo temático-categorial. Resultados: a pandemia revelou falhas na gestão dos serviços, falta de investimentos públicos e o despreparo dos profissionais, intensificando a fragmentação do trabalho, a desarticulação da rede, a desassistência e as práticas manicomiais pré-existentes. Conclusão: a realidade do cotidiano de trabalho dos serviços de atenção psicossocial mostra que são necessárias ações multifacetadas que considerem o processo social complexo da reforma psiquiátrica, especialmente, na pandemia, buscando a efetiva institucionalização do modelo de atenção psicossocial e a formação de núcleos de resistência ao modelo manicomial instituído. Descritores: Trabalho; Prática Institucional; Serviços de Saúde Mental; COVID-19. 1Universidade Federal de Mato Grosso. Cuiabá, MT, Brazil. 2Universidade de São Paulo. São Paulo, SP, Brazil. 3Universidade Federal de São Carlos. São Carlos, SP, Brazil. Corresponding author: Aline Delmondes Silvano Av. Tuiuiú, Quadra 55, 1, Morada da Serra, CEP: 78058-000. Cuiabá, MT, Brazil. E-mail: alinedelmondes.12@gmail.com EDITOR IN CHIEF: Ana Fatima Carvalho Fernandes ASSOCIATE EDITOR: Anderson Reis de Sousa Aline Delmondes Silvano1 Larissa de Almeida Rezio1 Felipe Aureliano Martins2 Marina Nolli Bittencourt1 Mirelly Thaina de Oliveira Cebalho1 Ana Karolina Lobo da Silva1 Flavio Adriano Borges3 How to cite this article: Silvano AD, Rezio LA, Martins FA, Bittencourt MN, Cebalho MTO, Silva AKL, et al. Psychosocial Care Center: daily work and articulation with the network in the pandemic. Rev Rene. 2022;23:e71660. DOI: https://doi.org/10.15253/2175-6783.20222371660 Conflict of interest: the authors have declared that there is no conflict of interest. Silvano AD, Rezio LA, Martins FA, Bittencourt MN, Cebalho MTO, Silva AKL, et al Rev Rene. 2022;23:e71660. 2 Introduction Among the advances that the Brazilian Psychiatric Reform, which began in 1980, brought to the care of people with mental disorders and needs arising from the use of alcohol and drugs, the creation of the Psychosocial Care Network stands out, since this was essential for the strengthening of psychosocial care of users and for the decentralization of services, seeking to articulate actions and health services and ensuring individualized, inter-professional, comprehensive, humanized, territorial, and free mental health care focused on ensuring autonomy and social reintegration(1). Therefore, among the various components of the Psychosocial Care Network, the following stand out: the Family Health Strategy teams that make up the Primary Health Care; the Mobile Emergency Care Service and the Emergency Care Units, in addition to the Psychosocial Care Centers and Polyclinics that, respectively, treat severe and persistent cases and provide outpatient care. In addition, other health services and community devices also make up the network, such as the Social Assistance Reference Center, Public Ministry, schools, churches, and hospitals(2). However, despite the strengthening that the Psychosocial Care Network brought to the Brazilian Psychiatric Reform movement, several factors have influenced, in a negative way, the continuity of this movement. Some examples are the various cuts made in the funding of the Unified Health System and the pandemic that further strengthened the risks of discontinuity of mental health care provided by the network, since the services needed to remodel themselves to follow the prevention standards of Coronavirus disease 2019 (COVID-19). At the same time, the services experience a considerable increase in the demand for mental health with the prospect of a worsening in the situation, even after the relaxation or suspension of isolation measures due to the scarcity of resources in the services, worsening of socioeconomic circumstances and others(3) . These remodels have imposed new ways of organizing mental health work, such as the need to reorganize triage and referral flows, the adoption of telehealth and digital interventions, the creation of new means of bonding and support networks, among others, which make the context conducive to understanding the impacts of these changes on mental health care, besides being a potential analyzer for already established practices(4-8). In this sense, studies that aim to analyze the effects of the pandemic on the daily work of the mental health service and its articulation with the other devices of the network, in order to identify the deficiencies and potentialities revealed and/or intensified by the pandemic, will allow us to reflect on the instituted and instituting movements that occurred in the specialized services of the Psychosocial Care Network during the pandemic context, so that we can propose/ establish practices more aligned to psychosocial care in moments of crisis such as this. Thus, this study aimed to analyze the daily work of a Psychosocial Care Center and its articulation with the Psychosocial Care Network in the context of the COVID-19 pandemic.