Mental health and suicide prevention: the contradictory access in a reference city of southern Brazil

depression woman

(Brut Carniollus, Unsplash)

This article was exclusively written for The European Sting by Ms. Mariele de Paula, 3rd year in medical school, academic from Ingá University Center (Uningá), member of the International Federation of Medical Student Associations of Brazil. 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.


Maringá is a Brazilian city that occupies the third place in the list of the most populous of its state, Paraná. According to the Ministry of Health from Brazil (DATASUS), Maringá has a per capita suicide rate of 5.70, while the national rate is 5.01.

Starfield (2002) explains the difference between the concepts of access and accessibility. The second one refers to the fact that people come to services and the first one use of services in order to meet the user’s needs in a resolute way.

In this sense, Maringá, even with a huge structural in the accessibility of treatment of mental illness, about thirty-eight Basic Health Units (UBS) with one psychologist in each unit, nine teams of the Family Health Care Center, Public Psychiatric Emergency Service, Mental Health Complex, with services from the Psychosocial Care Centers and the Intermunicipal Health Consortium, has a large deficit in access to services. Observing the flow of patients in the UBSs, it is clear that the initial reception in mental health is still very deficient in most of these units, as many employees are neither qualified nor motivated to serve the population looking for these services, unaware of the necessary information for the user benefit from proper access.

Considering that the suicidal population sometimes looks for primary care services before committing suicide attempts, we find at this point a chance to prevent them from occurring. Among the factors that hinder the effective access of users to health services in our region, the main ones are bureaucratization, the delay of actions and procedures and the long waiting time for consultation until getting access to multidisciplinary treatment.

These difficulties may be mainly related to the high flow of patients compared to the number of medical professionals and psychologists available at the UBSs, as well as the mismanagement of existing service strategies, such as community therapy, which allows reaching a large number of patients at the same time.

Therefore, the training of professionals involved in public health, especially those in primary care, is indispensable. These professionals should have strategies of approaches that allow effective access to public services by the patient, and become close to users, building reliance between them, which allows the expression of suicidal intent.

Thinking about the population that does not seek medical help, but are at risk, the Community Health Agents, after receiving specific training, could also be provided with strategies to approach and screen for suicidal behaviors of their assigned population during home visits. This screening can be facilitated by means of a mental health stratification questionnaire, which allows to detect risk factors for the development of mental disorders, such as depression, generalized anxiety, mood disorders, drug abuse, in order to refer and direct this patient directly to the indicated service, reducing the rate of undiagnosed psychiatric patients whose illness may be aggravated by lack of specialized treatment. In addition, attention to the psychiatric patient should be given in an integral and continuous manner, aiming at protection against possible crises.

References

ABREU, K. P. et al. Comportamento suicida: fatores de risco e intervenções preventivas. Revista eletrônica de enfermagem, v. 12, n. 1, 2010.

BOTTI, N. C. L. et al. Características e fatores de risco do comportamento suicida entre homens e mulheres com transtornos psiquiátricos. Cogitare Enfermagem, v. 23, n. 2, 2018.

CAMPOS, R. T. O. et al. Avaliação da qualidade do acesso na atenção primária de uma grande cidade brasileira na perspectiva dos usuários. Saúde em Debate, v. 38, p. 252-264, 2014.

DATASUS Ministério da Saúde.Sistema de Informações sobre Mortalidade (SIM). Access 21/08/2019, available in: http://tabnet.datasus.gov.br/cgi/deftohtm.exe?sim/cnv/ext10br.def

IBGE. Instituto Brasileiro de Geografia e Estatística. Access 21/08/2019, available in: https://cidades.ibge.gov.br/brasil/pr/maringa/panorama

Maringá é referência nacional em atendimento à saúde mental. Access 21/08/2019, available in: http://www2.maringa.pr.gov.br/site/index.php?sessao=88b1d65db75588&id=33466

PADILHA, C. S.; OLIVEIRA, W. F. Terapia comunitária: prática relatada pelos profissionais da rede SUS de Santa Catarina, Brasil. Interface-Comunicação, Saúde, Educação, v. 16, n. 43, p. 1069-1086, 2012.

About the author

Mariele de Paula, 3rd year in medical school, academic from Ingá University Center (Uningá), member of the International Federation of Medical Student Associations of Brazil and extension director of academic league of medical genetics. Raphaela Montalvão Morais and Giovanna Furini Lazaretti both of 3rd year in medical school, academics from Ingá University Center. These students from the same year and localities articulated themselves with the objective of reporting and solving a current problem that has occurred in their city.

Advertising

the sting Milestone

Featured Stings

Stopping antimicrobial resistance would cost just USD 2 per person a year

Can we feed everyone without unleashing disaster? Read on

These campaigners want to give a quarter of the UK back to nature

How to build a more resilient and inclusive global system

How the media can be a meaningful stakeholder in the quest to meet the SDGs

Migration: Better travel safe than sorry

Release of prize-winning Reuters journalists in Myanmar welcomed by UN

How distorted is the EU labour market by this crisis?

What if Trump wins the November election and Renzi loses the December referendum?

Why is the World Health Organisation so much needed?

Stop violence against women: Statement by the European Commission and the High Representative

After Brexit and Grexit, Brussels to deal with Poloust

EU Youth Conference concludes in Luxembourg with concrete plans on how to create real youth participation

De-escalate now, to steer Yemen off ‘precarious path’, UN Security Council hears

JADE Spring Meeting 2017 – day 3: JADE Academy trainings, networking session and gala dinner – Excellence Awards winners revealed

It’s time to ‘eliminate the scourge of conflict-related sexual violence’, urges UN chief

South Korea: A cherished partner for the EU

Costa Rica is one of the world’s happiest countries. Here’s what it does differently

UN Security Council condemns Taliban offensive as a blow against ‘sustainable peace’

Cum-ex tax fraud scandal: MEPs call for inquiry, justice, and stronger tax authorities

Barcelona’s ‘superblocks’ could save lives and cut pollution, says report

The European Sting @ European Business Summit 2014 – the preview

Mergers: Commission opens in-depth investigation into joint ventures proposed by Boeing and Embraer

AI will drive the societies of the future. Will the governed consent?

Trade in fake Italian goods costs economy billions of euros

Diversity training doesn’t change people’s behaviour. We need to find out what does

UN Security Council welcomes results of Mali’s presidential elections

The Stray

Syria: A bloody tracer of Trump – Putin rapprochement

Drought in Europe: Commission presents additional measures to support farmers

World cannot be transformed without ‘ingenuity of the countries of the South’: UN Chief

Women’s voices must be heard in the battle to save the ocean

Climate emergency: City mayors are ‘world’s first responders’, says UN chief

How data can empower patients to personalize and improve their cancer treatment

New round of bargaining for the 2014 EU budget late in autumn

No better year for the EU’s weak chain links

Shaping Europe’s digital future: op-ed by Ursula von der Leyen, President of the European Commission

German opposition win in Lower Saxony felt all over Europe

Cities are easy prey for cybercriminals. Here’s how they can fight back

Treaty prohibiting nuclear weapons marks first anniversary, but still lacks sufficient numbers to become law

In 2020 Asia will have the world’s largest GDP. Here’s what that means

Iraqis paying an ‘unthinkable price’ to be heard, UN envoy tells politicians in Baghdad

The COP22 is under full deployment while Donald Trump threatens openly to withdraw the US from the Paris agreement

E-Governance: A powerful tool to combat, mitigate and sustainably manage disaster risks

7 ways for businesses to capture the youth dividend

Coronavirus: Commission offers financing to innovative vaccines company CureVac

Privatization of the health sector and the right to receive treatment

These LGBTQI Davos leaders shared their advice on coming out

More funds needed to counter ‘persistent and multi-faceted humanitarian problems’ in Ethiopia

Youth Forum welcomes European Commission proposal to speed up financing for youth employment

International Court of Justice orders Pakistan to review death penalty for Indian accused of spying

Exchanges of medical students and the true understanding of global health issues

‘We are nowhere closer’ to Israeli-Palestinian peace deal, than a year ago, Security Council hears

Future Forces Forum: Prague will be hosting the most important project in the field of Defence and Security

‘Starvation’ now a reality for displaced Syrians stranded in camp near Jordanian border

Look to cities, not nation-states, to solve our biggest challenges

COP25: Developing nation’s strike hard

Top UN official urges Russia and Ukraine to step away from further confrontation at sea

Why exchange programs are essential for the medical students of the 21st century

Ebola: EU announces new funds to strengthen preparedness in Burundi

The hidden downsides of autonomous vehicles – and how to avoid them

3 ways to fix the way we fund humanitarian relief

Sustainable fishing staying afloat in developed world, sinking in poorer regions

More Stings?

Speak your Mind Here

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s