O processo de alta de crianças e adolescentes em CAPSij na perspectiva de terapeutas ocupacionais

Abstract

Current health policies and guidelines have highlighted the relevance of a practice that is efficient, effective, and resolutive. This trend has been established throughout the Health Care Network, including the Psychosocial Care Network. Thus, a scenario is developed that calls for the expansion of the discussion about discharging processes, also in the services of mental health care for children and adolescents of Unified Health System (SUS). In the national and international literature, there is a shortage of studies that address the theme of the contribution of occupational therapy in the discharging process of children and adolescents in the field of mental health, as well as discharging processes in general. Thus, the objective of this study was to understand the children and adolescents’ discharging process at Child Psychosocial Care Centers (CAPSij) from the perspective of occupational therapists. For this purpose, a descriptive and exploratory field study was carried out with a qualitative approach. The target population consisted of 15 occupational therapists working at CAPSij in the city of São Paulo, with experience for at least one year. Data were collected through a semi-structured interview and analyzed using the Collective Subject Discourse (DSC) technique. The results of this study demonstrated how the discharge process of children and adolescents occurs at CAPSij, considering the aspects related to the understanding and use of the term “discharge” in this context, the description of how it happens, the reflection on its criteria and its challenges in practice; in addition to the perception of children, adolescents and families regarding the discharge process. It was also identified that the occupational therapists involved in this study participate in the discharging processes in the context of the CAPSij in which they work, either as a member of the multi-professional team or as a professional in the area of occupational therapy. It was observed that the contribution of occupational therapy in the discharging process is related to a more extensive and contextualized evaluation and analysis of the child / adolescent candidate for discharge, to the strengthening of the families, to acting as a technical reference of the users, to the work shared with the interdisciplinary team and the empowerment of the subjects for appropriation of the social spaces extra-wall CAPSij. It was found that the implementation of the technical reference function, the active participation of the child / adolescent / family, the articulation of the CAPSij with the intersectoral network, and the reflection about the concepts of "discharge" and "referral" in the context of child and adolescent mental health are determining factors for the process of discharging children and adolescents who experience psychic suffering to occur in an implicated, co-responsible and safe manner. Regarding the participation of occupational therapy in the discharging process, there was progress in relation to the actions of these professionals within the scope of the child and adolescent mental health, which have been highlighted in an expanded, concrete and contextualized way, in response to the current demands of this field. It is considered that this research was able to deepen the understanding and discussion about the discharging process, either approaching it in its specificities, or in its broader aspects, thus contributing both to the production of knowledge in the field of child and adolescent mental health as well as to health mental and occupational therapy.