A rede de atenção psicossocial na 10a Regional de Saúde do Paraná e o atendimento destinado a crianças e adolescentes vítimas de violências

Abstract

Violence is a multifactorial phenomenon; their various determinations intersect and produce the most different effects. The experience of violence can represent a serious risk factor for the cognitive, emotional and social development of victims. It can, in this sense, compromise development throughout the individual's life cycle. Objective: To describe how the psychosocial care network is organized for the care of children and adolescents who are victims of violence in the municipalities of the 10th Regional Health Region of Paraná. Methodology: This is a descriptive and quantitative-qualitative research that was divided into two moments: the first deals with an integrative literature review, with the purpose of subsidizing information on the subject and investigating the gaps for the development of the second moment, namely field research, which is presented in an epidemiological and quantitative study and; another descriptive and qualitative. Results: Regarding the integrative review, 96 publications were obtained, applying the inclusion and exclusion criteria, of which 92 were excluded, leaving four for analysis. It was identified that the least recent study was from 2018 and the most current study is from 2022. Regarding the type of studies, all are qualitative research, published in Psychology journals; (25%) of Psychology and Psychiatry; and (25%) in Nursing. In the thematic analysis, two categories were identified: the first category identified allows the analysis of network action and care for children and adolescents who are victims of violence; and the second is based on reporting aspects related to the dynamics of care directed to victims of violence. Regarding the epidemiological and quantitative study, it was identified that among the years surveyed, 5,670 cases were reported in the 10th Regional Health Region; in Paraná, 83,109; in Brazil, 678,108. Regarding the victim's gender, there is a prevalence of female. . The age of the victims in the Regional is concentrated between 01 and 04 years, differing from the national and state data, which focus on 15 to 19 years. The aggressor's bond predominantly refers to the person of the mother and, in relation to age, is concentrated in the adult phase, between 25 and 59 years old. The gender of the attacker is predominantly female. And the violence with the highest incidence is negligence and physical aggression. And finally, in the descriptive and qualitative study, professionals representing 12 municipalities and 01 professional who works directly in the Regional Health Department participated in the research, totaling 13 participants. It should be noted that the 10th Regional Health Region 10 is composed of 25 municipalities. After the analysis and systematization of the data, considering the assumptions of Minayo (2012), four thematic categories were identified, namely: 1) Composition, understanding and performance of the Psychosocial Care Network - RAPS; 2) Fragility of the flows and intersectoral action of the protection network in the care of children and adolescents who are victims of violence; 3) Perspectives on violence: the violating agent, the damage caused and the rights provided for by law; 4) The inefficiency of public policies in the protection of children and adolescents who are victims of violence Conclusion: When performing the analysis of the integrative review, considering the selected articles, two analytical categories were identified. The first allowed us to analyze network action, the studies indicated fragility in intersectoral action; The second category allowed us to verify that mental health care is preferentially directed to individuals, with reports only in CAPS, and also a single report that mentioned interventions aimed at families. Regarding the epidemiological study, it can be stated that situations of violence are present in the 10th Regional Health Region and are similar to state and national data. The considerations of this study point to the strong need to pay attention to families, so that they can receive necessary interventions, so that they can provide care for the children and adolescents who make up these family groups, breaking with cycles of domestic/intrafamily violence. And, finally, the descriptive and qualitative study points out about the weaknesses in the exercise and construction of mental health care lines aimed at children and adolescents who are affected by the experiences of violence. With regard to the sectoral and intersectoral flows of care for children and adolescents who are victims of violence, there were no objective and formalized flows. This study ends without a clear description of mental health care for children and adolescents who are victims of violence. The analyses allowed us to problematize the performance in mental health in small municipalities and the challenges for the effectiveness of the psychosocial care network in these territories. The study points to the opportunity for greater scientific exploration on the subject, and it is important to continue the discussion, in order to contribute to the management, organization and effectiveness of the Psychosocial Care Networks, in the search for comprehensive care for children and adolescents who are victims of violence.