Mental health and suicide prevention: why focus on primary care

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(Mitch Lensink, Unsplash)

This article was exclusively written for The European Sting by Ms. Thaís Queiroz Landi, fourth-year medical student at the São Lucas University Center, in Rondônia. She is affiliated to the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writer and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.


According to the World Health Organization (WHO), each year more than 800,000 people commit suicide, with mental disorders behind 98% of these deaths. The lack of information is reflected in the number of deaths. These data lead us to reflect on the importance of mental health and the impact that mental illness can have on a person.

In Brazil, the Unified Health System (SUS) offers all Brazilian citizens free and universal access to health services. This system is organized into three levels of attention: primary, secondary and tertiary. At the primary level, appointments, examinations and basic procedures are scheduled. Besides, professionals work not only in the Basic Health Unit, but also serve the community, with home visits to families in the region.

Secondary Care is formed by specialized services at the outpatient and hospital level, with the experience of specialist doctors. Tertiary Attention is responsible for performing high expertise, high technology, and high-cost interventions.

In the state of Rondônia, it is noted that primary care professionals are not always able to deal with people in mental distress, which results in a neglect in the care of these patients, who end up treating only symptoms secondary to their mental illness. To change this scenario, it is of paramount importance that this health team is qualified to correctly identify and conduct individuals with mental illness from the first visit. Therefore, the qualification of primary level professionals is essential as it is the gateway to our health care system.

Primary care staff should be able to identify, treat, and refer patients with mental disorders as needed. After identification, it is necessary to investigate the current mental state of the individual, if he has depressive symptoms or suicidal thoughts, relies on the support of family or friends and after a thorough approach, clarify doubts and offer support to the suffering person, aiming to strengthen the bond between professional and patient.

This bond is necessary because even if the patient is referred to a specialist, he remains under long-term care by the primary care team while living in the same neighborhood. Therefore, access to information coupled with the bond between professional, patient and family increases the form or access to health. This comprehensive care strategy can help with long-term control, improve patient-family relationships, and decrease the recurrence of attempted suicide.

References

MACEDO, L. M; MARTIN, S. T. F. Interdependence between the levels of care in Brazilian Health System (SUS): meanings of integrality reported by primary care workers. São Paulo: Interface; 2014. Available in: <http://www.scielo.br/pdf/icse/2014nahead/1807-5762-icse-1807-576220140597.pdf>. Access in: 19 set. 2019.

AZEVEDO, A. L. C. S. et al. Organização de serviços de emergência hospitalar: uma revisão integrativa de pesquisas [internet]. Revista Eletrônica de Enfermagem. São Paulo: 2010. Available in: <http://www.fen.ufg.br/revista/v12/n4/v12n4a20.htm>. Access in: 20 set. 2019.

CARDOSO, L; GALERA, F. A. S. O cuidado em saúde mental na atualidade. São Paulo: 2010. Available in: <http://www.scielo.br/pdf/reeusp/v45n3/v45n3a20.pdf>. Access in: 21 set. 2019.

About the author

Thaís Queiroz Landi, fourth-year medical student at the São Lucas University
Center, in Rondônia. Member of the Standing Committee on Sexual and
Reproductive Health and Rights, including HIV and AIDS (SCORA), of IFMSA
Brazil. She is also a member and founder of the League of Mastology and
Oncoplastic of Rondônia. Since the beginning of her academic life, she has
been interested in the mental health field, acting in campaigns about the
importance of this theme.

Comments

  1. I absolutely agree with what you have written. What concerned me most is WHO figures that 98% of suicides have mental health issues. I note hearing that Cuba like Brazil has an excellent provision of health at primary, secondary and tertiary; I wish this was the case in Ireland. Primary care is essential. They say that if there is true Justice in a country there is no need for charities, well in Ireland we have so many mental health charities with an inadequate mental provision for people especially young people. Worse again is where the Health provision board known as the HSE provides funding to the charities to basically prop up a system that is failing our people. Primary care visits to the home used to happen in Ireland. My parents were dispensary doctors in what were rural settings then (not now). If you visit a patient’s home you can learn so much about the health of the patient and then it is easier to make the necessary interventions. 4th year student. Good luck in your quest. Your article is most informative. Personally mental illness is the Black Dog that is an integral part of my life. I found solace in bibliotherapy; writing; medication and good people. If you Google canisgallicus.com search mental health/suicide you will find some of my writings on the subject. 25+ yrs ago I fractured my skull in a horse riding accident; then 2017 it was breast cancer so I decided to write book Fortune Favours the Brave. https://www.amazon.co.uk.dp.1912639610/ Quotes are a good friend of mine also and this life is so much about overcoming obstacles.

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