Saúde mental para refugiados: estudo exploratório das dimensões teórico-conceitual e técnico-assistencial

Abstract

In recent years, the phenomenon of forced migration has gained prominence in the global agenda and, with it, the repercussions on the mental health of the refugee population stand out as an important topic in global health. The issue involves the Brazil, a country inserted in the destination and transit flows of this population. This job of completion of residency is part of this juncture dedicating itself to thinking about the actions and experiences in mental health for the refugee population. Therefore, a literature review was carried out with searches in December 2018 at the Library Virtual in Health and in the SciELO database, using the descriptors and terms "refugees", “Health” and “Mental Health”. Complete articles in Portuguese were selected published from 2013 to 2018 that had the term “refuge” or variation in the summary. Only empirical publications that narrated their actions and experiences in health with refugee groups/individuals. resulted from searches nine articles published in journals based in Brazil, which were explored from two dimensions of the Brazilian Psychiatric Reform: technical-assistance and theoretical-conceptual. In the technical-assistance dimension, it was verified in the experiences occurred in Brazil and abroad the recurrent presence of outpatient services specialized in the mental health of immigrants and refugees. in the experiences in particular, arrangements were observed between civil organizations (religious, psychoanalytic and others), international organizations and the State in its administrative legal form. There was a low presence of teams multi-professionals, Brazilian public services and logic equipment community and territorial. In the theoretical-conceptual dimension, they expressed themselves representations of refugees around racial issues, relationship between individual and the State, from the perspective of insecurity, risk, the traumatized subject and the individual in identity crisis. The interrelationships between trauma were discussed, exile and culture present in the publications. Reflections on culture in the scope manifested mainly in the figure of refugees and little in that of the health professionals and their techniques or diagnoses. Still in the conceptual theoretical dimension, the relationship between memory and trauma in its plurals was discussed. presentations: radical impossibility of transcribing memories, the use of history for links with the social bond, political uses of memories and productive uses to a new life through forgettings. It is concluded that the results point to trauma and culture as transversal to the themes, however, with dissonances and pluralities in the field of mental health for refugees among psi knowledge and sociologizing perspectives. Such relationships of knowledge meet in dispute and fusion, it is not possible to polarize them or try to summarize them to the theme of the trauma. Trauma is extrapolated and a number of other concerns are found associated with human rights, culturalities, religion, racism, memory and policy.