Você não sabe o que eu caminhei para chegar até aqui: Sofrimento psíquico e itinerários terapêuticos em contextos quilombolas

Abstract

The rural and quilombola populations experience different situations of exclusion in their daily lives, from access to land, education and health services. To overcome such difficulties, these populations develop in their own territories’ different ways of life from those found in urban areas. Specifically, regarding health issues, studies indicate that quilombola populations develop new health systems based on popular knowledge that span generations. This master´s dissertation aimed to analyze the conceptions of people that live in quilombola communities, who have been diagnosed with mental disorder and their family caregivers about mental health care and mental suffering. Therefore, two complementary studies were carried out, which constituted two articles. The first article aimed to analyze the conceptions about psychological distress and mental health care from the perspective of people living in quilombola communities, diagnosed with mental disorder. The second article analyzed the conceptions about psychological distress and mental health care by family members of people diagnosed with mental disorder and living in quilombola communities. Both studies are characterized as exploratory, descriptive, with qualitative approach. Nine people with a history of psychological distress and six family members/caregivers participated in the studies. All were chosen non probabilistically and for convenience. In the first study, is was used socio-demographic questionnaire and oral history interview (life report) for data recollection. For the second study, is was used a socio-demographic questionnaire and in-depth interview. Data analysis was performed through thematic categorical content analysis. In the first study, three thematic categories and ten subcategories were found. In general, the categories dealt with the participants´ perception of psychic suffering; the care strategies used by them in mental health care and family and community support. In the second study, four thematic categories emerged (Conceptions on psychic suffering; Care strategies; Mental health care in health services and Social Relations) and twelve subcategories. Family members report having little understanding about the mental disorder. However, family caregivers are involved in the care process. In both studies, the most relevant care practices were based on popular knowledge, such as the use of medicinal plants and religious practices, and biomedical knowledge, centered on the use of medication. The research demonstrated the need to strengthen Community and family bonds for better effectiveness of territorial care. It was also evidenced the absence of public policies in the territories and the need for approximation and dialogue between the formal and informal system.