Perspectivas da população em situação de rua: saúde mental e cuidados oferecidos pelo SUS e SUAS

Abstract

The objective of this study was to investigate the relationship between the condition of being a homeless person, mental health and the care offered by the healthcare and social assistance network, examining specifically the interface between the Brazilian Unified Health System (SUS) and Unified Social Assistance System (SUAS). Empirical data were collected via 22 semi-structured interviews, 18 of which were conducted with homeless people and 4 with professionals from the Centro POP (Day Center), Consultório na Rua (Mobile Health Unit) and an Emergency Shelter of a medium-sized city in the interior of the State of São Paulo. The collected data were analyzed using the Thematic Content Analysis technique, following the example of key authors within the area of Social Psychology and public policy, and yielded descriptive and interpretive results. Participants’ remarks were organized into the following analytical categories: 1. Homelessness: psychosocial determinants and the dialectic relationship between difficulties and potentialities; 2. Mental Health: meanings and the dialectic relationship between suffering and well-being, needs and desires; 3. Care and Services; 4. Pandemic. The hypotheses of this study were confirmed: the homeless population has specific mental health demands due to psychosocial vulnerabilities brought about by their living conditions; these demands are partially met by the services offered within the health and social network. However, although it was found that some services offered directly benefit mental health, there is a need for actions that more directly relate to this scope and more effectively minimize vulnerabilities in this population. Thus, this study showed a complex interrelationship between the dimensions Homelessness, Mental Health and Public Policies, as well as the dialectical interaction between the vulnerabilities and strengths of these ways of life, between suffering and resources, between risk factors and protection, between needs and desires. There is still a need for more studies that critically discuss the issue, as these are still scarce, reinforcing the invisibility that is so common to homeless people.