E no meio do caminho, tinha uma pandemia: caminhos e descaminhos da produção de cuidado em saúde mental durante a pandemia da Covid-19 por Agentes Comunitárias de Saúde

Abstract

March 2020 was marked as the beginning of the Covid-19 pandemic. Considered one of the most important epidemics since the beginning of the century, the consequences of the presence of Sars-Cov-2 in our daily lives highlighted care practices, considering that different social groups became ill and lived with the virus in different ways. Among the impacts experienced, the psychological suffering and mental health of populations stand out, whether due to the direct effects of illness or virus containment measures, with social isolation, as well as access to protective resources during the emergency period. in health. Given the scenario described, this dissertation aimed to investigate mental health care practices carried out by Community Health Agents (CHA) following the Covid-19 pandemic. Considering the marked presence of CHAs in the territory and their role as a link with the community, the researcher bet on this group of professionals as those who could more reliably point out the ways in which the community faced the Covid-19 pandemic in their daily lives. Access to the knowledge and experiences accumulated by the CHAs was possible through the researcher's rapprochement with the health team of a neighborhood located in the city of Juiz de Fora. Os registros desses encontros e trocas foram feitos em diários de campo e através da gravação em áudio das duas rodas de conversa que aconteceram com as ACS no interior da unidade de saúde. As caminhadas comunitárias também integraram as estratégias de investigação e estreitamento das relações com o cotidiano da comunidade e foram realizadas ao longo dos primeiros meses do ano de 2023. As categorias de análise delimitadas a partir do material acumulado foram as seguintes: 1) Covid-19 e seus desdobramentos na vida da comunidade; 2) mudanças na forma de cuidar; 3) estratégias de enfrentamento durante a pandemia de Covid-19; 4) concepções de saúde mental; e 5) a escuta ordinária. A criação de cenas e adaptação de narrativas, a partir dos contatos com a comunidade, tiveram como objetivo aproximar o leitor do que foi vivenciado pela pesquisadora em campo. Os resultados, apresentados a partir de cenas e com foco nas mesmas narrativas, indicaram o formato que as relações de cuidado entre profissionais e comunidade ganharam ao longo da pandemia da covid-19, com ênfase na saúde mental deste coletivo. Fica em evidência ao fim da pesquisa a múltipla dimensão dos impactos da pandemia da covid-19 no cotidiano de trabalho das ACS, provocando mudanças nos processos de trabalho e impondo a criação de estratégias de enfrentamento. Encontramos elementos desde a inserção de uma ferramenta de comunicação digital com a comunidade até a identificação de mudanças nos processos de trabalho da APS, com foco na produção e quantitativos, até a pouca participação das ACS em processos decisórios. The records of these meetings and exchanges were made in field diaries and through the audio recording of the two conversation circles that took place with the CHAs inside the health unit. The community walks were also part of the strategies for investigating and strengthening relationships with the daily life of the community and were held between January and June of 2023. The categories of analysis indicated the format that the care relationships between professionals and the community gained throughout the Covid-19 pandemic, with emphasis on the mental health of this collective. They were: 1) Covid-19 and its consequences in the life of the community; 2) changes in the way of caring; 3) coping strategies during the Covid-19 pandemic; 4) conceptions of mental health; and 5) ordinary listening. At the end of the research, the multiple dimensions of the impacts of the Covid-19 pandemic on the daily work of the CHAs are evident, among them, the changes in the work process of the health teams and their relationships with the community, the new contours given to care actions based on living with the virus, the way in which the CHAs welcomed mental suffering with an emphasis on dialogue, practice that guides the action of professionals even before the pandemic period, highlighting the bonding and welcoming as powerful work tools and consequent promotion of mental health care.