Assuntos
Hospitais Psiquiátricos , Serviços de Saúde Mental , Propriedade , Setor Privado , Humanos , Hospitais Psiquiátricos/economia , Hospitais Psiquiátricos/organização & administração , Serviços de Saúde Mental/economia , Serviços de Saúde Mental/organização & administração , Propriedade/economia , Propriedade/organização & administração , Setor Privado/economia , Estados Unidos , Mão de Obra em Saúde , Comércio , Qualidade da Assistência à Saúde , Acessibilidade aos Serviços de SaúdeRESUMO
The shift of mental health care from mental institutions to community-based services has been implemented differentially throughout the EU. However, because a comprehensive overview of the current mental health provision in member states is lacking, it is challenging to compare services across nations. This study investigates the extent of implementation of community-based mental health services within the EU using data collected from the WHO Mental Health Atlas. Results show that, although great cross-country variation exists in the implementation of community-based services, mental hospitals remain the prominent model of care in most countries. A few countries endorsed a balanced care model, with the co-occurrence of community services and mental hospitals. However, missing data, low quality of data and different service definitions hamper the possibility of a thorough analysis of the status on deinstitutionalization. Although policies on the closing and downsizing of mental institutions have been endorsed by the EU, the strong presence of mental hospitals slows down the shift towards community-based mental health care. This study highlights the need for an international consensus on definitions and a harmonization of indicators on mental health services. Together with the commitment of member states to improve the quality of data reporting, leadership must emerge to ensure quality monitoring of mental health-related data, which will help advance research, policies and practices.
Assuntos
Serviços Comunitários de Saúde Mental , União Europeia , Humanos , Serviços Comunitários de Saúde Mental/organização & administração , Hospitais Psiquiátricos/organização & administração , Política de Saúde , DesinstitucionalizaçãoRESUMO
In this paper, we provide insights into the interplay among the organizational, job, and attitudinal factors and employees' intentions to resign during the third wave of the COVID-19 pandemic at a mental health hospital. We point out shortcomings in the relationship dynamics between executive administration and operational staff and propose a pathway to develop more effective leadership frameworks to increase job satisfaction. We integrate qualitative data from case information and open-ended questions posed to employees at a mental health hospital and quantitative data from a small-scale survey (n = 19). We highlight that the ability to achieve objectives, work autonomy, burnout, affective commitment, distributive and procedural justice, and job satisfaction are critical in determining individuals' intentions to resign. Individuals identified disconnectedness and moral distress as critical aspects, while highlighting empathy, compassion, satisfaction, and confidence as pivotal elements. Mental healthcare settings could benefit from enhancing the staff's ability to achieve objectives, work autonomy, affective commitment, and both distributive and procedural justice. Addressing burnout and implementing measures to increase job satisfaction are equally vital. Efficiently restructuring dynamics between various leadership levels and staff can significantly improve employee retention.
Assuntos
Esgotamento Profissional , COVID-19 , Hospitais Psiquiátricos , Satisfação no Emprego , COVID-19/psicologia , COVID-19/epidemiologia , Humanos , Esgotamento Profissional/psicologia , Hospitais Psiquiátricos/organização & administração , Masculino , Adulto , SARS-CoV-2 , Feminino , Liderança , Pandemias , Inquéritos e Questionários , Pessoal de Saúde/psicologia , Pessoa de Meia-IdadeRESUMO
As part of mental health reform in Australia, new policies were introduced to support recovery-oriented practice; however, little has changed in hospital settings focused on managing risk and remediating acute symptoms. Previous studies have indicated that patients' experiences of personal recovery, during a hospital admission, may not mirror that of people living in the community, with patients being more likely to experience disconnection, hopelessness and disempowerment. Using a Participatory Health Research approach, eight mental health professionals, a patient advocate and an external researcher formed a research partnership to answer the question: How can staff enhance recovery-oriented practice in a hospital-based mental health service? The COREQ checklist was used for reporting the methods, analysis and findings. The methods comprised patient focus groups (n = 16 participants), interviews with managers (n = 7) and an online survey for staff (n = 17). Researchers analysed the feedback from the consultations using inductive thematic analysis, identifying two themes: relational recovery and recovery interventions. The findings indicate that relational recovery is key to recovery during a hospital admission and interventions that increase connectedness or reduce the impact of symptoms enhance personal recovery.
Assuntos
Grupos Focais , Transtornos Mentais , Humanos , Transtornos Mentais/terapia , Feminino , Masculino , Hospitais Psiquiátricos/organização & administração , Adulto , Entrevistas como Assunto , Pessoa de Meia-Idade , Serviços de Saúde Mental/organização & administraçãoRESUMO
OBJECTIVES: This systematic literature review synthesizes and assesses empirical research concerning the use of the built environment as a therapeutic intervention in adult mental health inpatient facilities. The review explores the impact of facility design on patient outcomes. BACKGROUND: There is a growing recognition that the built environment in mental health facilities must strike a balance between ensuring safety and providing a therapeutic atmosphere. A review addressing how facility design contributes to this therapeutic environment is warranted. METHODS: Database searches were conducted in CINAHL, Embase, PsychInfo, PubMed, and Web of Science from inception up to March 10, 2022. The Scottish Intercollegiate Guidelines Network (SIGN50) critical appraisal checklists were used to assess the quality of included studies. RESULTS: Of the 44 peer-reviewed studies identified from nine countries, several factors emerged as vital for the therapeutic environment in mental health inpatient facilities. These included personal spaces prioritizing privacy and control of the environment, daylight-optimized spaces, versatile communal areas promoting activities and interaction, designated areas for visits and spiritual/contemplative reflection, homelike environments, the inclusion of artwork in units, open nursing stations, and dedicated female-only areas. Yet, there is a need for research yielding stronger evidence-based designs harmonizing with therapeutic needs. CONCLUSION: This review offers initial guidance on designing mental health facilities that foster a therapeutic environment, while highlighting that the influence of facility design on mental health inpatients is considerably under-researched.
Assuntos
Ambiente Construído , Humanos , Arquitetura de Instituições de Saúde/métodos , Arquitetura Hospitalar/métodos , Hospitais Psiquiátricos/organização & administração , Transtornos Mentais/terapia , PrivacidadeRESUMO
BACKGROUND: High numbers of patients discharged from psychiatric hospital care are readmitted within a year. Peer support for discharge has been suggested as an approach to reducing readmission post-discharge. Implementation has been called for in policy, however, evidence of effectiveness from large rigorous trials is missing. We aimed to establish whether peer support for discharge reduces readmissions in the year post-discharge. METHODS: We report a parallel, two-group, individually randomised, controlled superiority trial, with trial personnel masked to allocation. Patients were adult psychiatric inpatients (age ≥18 years) with at least one previous admission in the preceding 2 years, excluding those who had a diagnosis of any organic mental disorder, or a primary diagnosis of learning disability, an eating disorder, or drug or alcohol dependency, recruited from seven state-funded mental health services in England. Patients were randomly assigned (1:1) to the intervention (peer support plus care as usual) or control (care as usual) groups by an in-house, online randomisation service, stratified by site and diagnostic group (psychotic disorders, personality disorders, and other eligible non-psychotic disorders) with randomly permuted blocks of randomly varying length to conceal the allocation sequence and achieve the allocation ratio. The peer support group received manual-based, one-to-one peer support, focused on building individual strengths and engaging with activities in the community, beginning during the index admission and continuing for 4 months after discharge, plus care as usual. Care as usual consisted of follow-up by community mental health services within 7 days of discharge. The primary outcome was psychiatric readmission 12 months after discharge (number of patients readmitted at least once), analysed on an intention-to-treat basis. All patients were included in a safety analysis, excluding those who withdrew consent for use of their data. The trial is registered with the ISRCTN registry, ISRCTN10043328. The trial was complete at the time of reporting. FINDINGS: Between Dec 1, 2016, and Feb 8, 2019, 590 patients were recruited and randomly assigned, with 294 allocated to peer support (287 included in the analysis after withdrawals and loss to follow-up), and 296 to care as usual (291 in the analysis). Mean age was 39·7 years (SD 13·7; range 18-75). 306 patients were women, 267 were men, three were transgender, and two preferred not to say. 353 patients were White, 94 were Black, African, Caribbean, or Black British, 68 were Asian or Asian British, 48 were of mixed or multiple ethnic groups, and 13 were of other ethnic groups. In the peer support group, 136 (47%) of 287 patients were readmitted at least once within 12 months of discharge. 146 (50%) of 291 were readmitted in the care as usual group. The adjusted risk ratio of readmission was 0·97 (95% CI 0·82-1·14; p=0·68), and the adjusted odds ratio for readmission was 0·93 (95% CI 0·66-1·30; p=0·68). The unadjusted risk difference was 0·03 (95% CI -0·11 to 0·05; p=0·51) in favour of the peer support group. Serious adverse events were infrequent (67 events) and similar between groups (34 in the peer support group, 33 in the care as usual group). Threat to life (self-harm) was the most common serious adverse event (35 [52%] of 67 serious adverse events). 391 other adverse events were reported, with self-harm (not life threatening) the most common (189 [48%] of 391). INTERPRETATION: One-to-one peer support for discharge from inpatient psychiatric care, plus care as usual, was not superior to care as usual alone in the 12 months after discharge. This definitive, high-quality trial addresses uncertainty in the evidence base and suggests that peer support should not be implemented to reduce readmission post-discharge for patients at risk of readmission. Further research needs to be done to improve engagement with peer support in high-need groups, and to explore differential effects of peer support for people from different ethnic communities. FUNDING: UK National Institute for Health Research.
Assuntos
Hospitais Psiquiátricos/organização & administração , Transtornos Mentais/terapia , Alta do Paciente/estatística & dados numéricos , Readmissão do Paciente/estatística & dados numéricos , Grupo Associado , Adulto , Idoso , Aconselhamento , Inglaterra , Feminino , Humanos , Masculino , Transtornos Mentais/psicologia , Pessoa de Meia-Idade , Método Simples-CegoRESUMO
RESUMO. No Brasil, o funcionamento das residências terapêuticas tende a apresentar desafios, tais como a falta de apoio social, que podem dificultar a produção do cuidado em saúde e afetar os trabalhadores do serviço. Por isso, a presente pesquisa tem como objetivo relatar a experiência de realização de oficinas com profissionais de uma residência terapêutica, além de descrever os desafios e potencialidades enfrentados pelos profissionais ao produzirem o cuidado em saúde. Para tanto, realizou-se um estudo qualitativo-descritivo, do tipo relato de experiência, embasado na abordagem metodológica do construcionismo social. Os dados foram coletados a partir de entrevistas semiestruturadas, gravadas, com cinco profissionais de uma residência terapêutica, seguidas por quatro oficinas, adaptadas a partir da Metodologia 'Ritmos da Vida', e diários de campo da pesquisadora. A partir dos relatos apresentados percebe-se que as participantes do estudo relataram muito mais desafios do que potencialidades para a produção do cuidado em saúde mental. Contudo, os espaços de fala e de escuta ofertados às profissionais parecem ter disponibilizado reflexões que possibilitaram a construção de sentidos positivos relacionados ao trabalho em saúde mental.
RESUMEN. En el Brasil, el funcionamiento de las residencias terapéuticas tiende a presentar desafíos, como la falta de apoyo social, que pueden dificultar la producción del cuidado en salud y afectar a los trabajadores del servicio. Por eso, la presente investigación tiene como objetivo relatar la experiencia de realización de talleres con profesionales de una residencia terapéutica, además describir los desafíos y potencialidades enfrentados por los profesionales al producir el cuidado en salud. Para ello, se realizó un estudio cualitativo-descriptivo, del tipo relato de experiencia, basado en el enfoque metodológico del construccionismo social. Los datos fueron recolectados a partir de entrevistas semiestructuradas, grabadas, con cinco profesionales de una residencia terapéutica, seguidas por cuatro talleres, adaptados a partir de la Metodología 'Ritmos da Vida', y diarios de campo de la investigadora. A partir de los relatos presentados se percibe que las participantes del estudio relataron mucho más desafíos que potencialidades para la producción del cuidado en salud mental. Sin embargo, los espacios de habla y de escucha ofrecidos a las profesionales parecen haber ofrecido reflexiones que posibilitaron la construcción de sentidos positivos relacionados con el trabajo en salud mental.
ABSTRACT. n Brazil, the functioning of therapeutic residences tends to present challenges, such as the lack of social support, which can hinder the production of health care and affect the workers of the service. Therefore, this study aimed to report the experience of conducting workshops with professionals of a therapeutic residence, besides describing the challenges and potentialities faced by professionals when producing health care. To this end, a qualitative-descriptive study, experience report was carried out, based on the social constructionism approach. Data were collected from semi-structured interviews, recorded, with five professionals of a therapeutic residence, followed by four workshops, adapted from the methodology 'Rhythms of Life', and field diaries of the first author. From the reports presented, the study participants clearly reported many more challenges than potentialities to produce mental health care. However, the spaces for talking and listening offered to professionals seem to have provided reflections that enabled the construction of positive meanings related to mental health work.
Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Terapêutica/psicologia , Saúde Mental , Pessoal de Saúde , Hospitais Psiquiátricos/organização & administração , Apoio Social , Sistema Único de Saúde , Afeto , Atenção à Saúde , Política de SaúdeRESUMO
In their paper, Stelnicki and Carleton (2021) highlight both the findings of their 2019 survey of nurses' mental health (Stelnicki et al. 2020) and more recent literature published during the COVID-19 pandemic. This response outlines the role of nursing leaders in enabling the mental health of nurses in a mental health and addiction setting, particularly during the COVID-19 pandemic.
Assuntos
Recursos Humanos de Enfermagem Hospitalar/psicologia , Equipe de Assistência ao Paciente/organização & administração , Enfermagem Psiquiátrica/organização & administração , Resiliência Psicológica , COVID-19/epidemiologia , COVID-19/prevenção & controle , Hospitais Psiquiátricos/organização & administração , Humanos , Controle de Infecções/normas , Liderança , Ontário/epidemiologia , Pandemias , SARS-CoV-2RESUMO
Healthcare providers (HCPs) working at point of care with patients have experienced health-, home- and work-related stressors from the COVID-19 pandemic. The magnitude and duration of the pandemic pose particular challenges for nursing leadership, and there is little research to guide them during this unprecedented time. This study was designed to explore how the pandemic influences HCP well-being, professional practice, inter-professional collaboration and the education and supports that would assist them during the pandemic recovery period. The article reports on the qualitative portion of a mixed-methods study, which included 56 HCPs who work in a large mental healthcare facility in Ontario. Witnessing the impact of the pandemic restrictions on patients was a significant source of stress for HCPs. HCPs recommended strategies, such as learning new therapeutic modalities and participating in the redesign of health services as key strategies to support them during the pandemic as these would promote patient well-being. Lastly, the pandemic provided opportunities for HCPs to deepen their understanding of other professions. This awareness was viewed as a strength that could support interprofessional collaboration and enhance health services redesign. The findings and recommendations can assist leaders to address the mental health challenges arising from the pandemic.
Assuntos
COVID-19/psicologia , Pessoal de Saúde/psicologia , Hospitais Psiquiátricos/organização & administração , Liderança , COVID-19/epidemiologia , Pessoal de Saúde/educação , Humanos , Relações Interprofissionais , Pandemias , Pesquisa Qualitativa , SARS-CoV-2 , Inquéritos e QuestionáriosRESUMO
Importance: Transgender and gender diverse (TGD) individuals, who have a gender identity that differs from their sex assigned at birth, are at increased risk of mental health problems, including depression, anxiety, self-injurious behavior, and suicidality, relative to cisgender peers. Objective: To examine mental health outcomes among TGD vs cisgender adolescents in residential treatment. Design, Setting, and Participants: This cohort study's longitudinal design was used to compare groups at treatment entry and discharge, and 1-month postdischarge follow-up. The setting was an adolescent acute residential treatment program for psychiatric disorders. Participants were TGD or cisgender adolescents enrolled in the treatment program. Statistical analysis was performed October 2019 to March 2021. Exposure: Adolescents participated in a 2-week acute residential treatment program for psychiatric disorders. Main Outcomes and Measures: Primary outcomes were depressive (the Center for Epidemiologic Studies Depression Scale [CES-D]) and anxiety (the Multidimensional Anxiety Scale for Children [MASC]) symptoms, and emotional dysregulation (the Difficulties in Emotion Regulation Scale [DERS]), measured at treatment entry and discharge, and postdischarge follow-up. Age of depression onset, suicidality, self-injury, and childhood trauma also were assessed at treatment entry. Results: Of 200 adolescent participants who completed treatment entry and discharge assessments, the mean (SD) age was 16.2 (1.5) years; 109 reported being assigned female at birth (54.5%), 35 were TGD (17.5%), and 66 (49.3%) completed 1-month follow-up. TGD participants had an earlier mean (SD) age of depression onset (TGD: 10.8 [2.4] years vs cisgender: 11.9 [2.3] years; difference: 1.07 years; 95% CI, 0.14-2.01 years; P = .02), higher mean (SD) suicidality scores (TGD: 44.4 [23.1] vs cisgender: 28.5 [25.4]; difference: 16.0; 95% CI, 6.4-25.5; P = .001), more self-injurious behavior (mean [SD] RBQ-A score for TGD: 3.1 [2.5] vs cisgender: 1.7 [1.9]; difference: 1.42; 95% CI, 0.69-2.21; P = .001) and more childhood trauma (eg, mean [SD] CTQ-SF score for emotional abuse in TGD: 12.7 [5.4] vs cisgender: 9.8 [4.7]; difference: 2.85; 95% CI, 1.06-4.64; P = .002). The TGD group also had higher symptom scores (CES-D mean difference: 7.69; 95% CI, 3.30 to 12.08; P < .001; MASC mean difference: 7.56; 95% CI, 0.46 to 14.66; P = .04; and DERS mean difference: 18.43; 95% CI, 8.39 to 28.47; P < .001). Symptom scores were significantly higher at entry vs discharge (CES-D mean difference, -12.16; 95% CI, -14.50 to -9.80; P < .001; MASC mean difference: -3.79; 95% CI, -6.16 to -1.42; P = .02; and DERS mean difference: -6.37; 95% CI, -10.80 to -1.94; P = .05) and follow-up (CES-D mean difference: -9.69; 95% CI, -13.0 to -6.42; P < .001; MASC mean difference: -6.92; 95% CI, -10.25 to -3.59; P < .001; and DERS mean difference: -12.47; 95% CI, -18.68 to -6.26; P < .001). Conclusions and Relevance: This cohort study found mental health disparities in TGD youth relative to cisgender youth, with worse scores observed across assessment time points. For all participants, primary clinical outcome measures were significantly lower at treatment discharge than at entry, with no significant differences between discharge and 1-month follow-up. Given the substantial degree of mental health disparities reported in TGD individuals, these findings warrant focused clinical attention to optimize treatment outcomes in gender minority populations.
Assuntos
Comportamento do Adolescente/psicologia , Hospitais Psiquiátricos/normas , Tratamento Domiciliar/normas , Pessoas Transgênero/psicologia , Adolescente , Feminino , Hospitais Psiquiátricos/organização & administração , Hospitais Psiquiátricos/estatística & dados numéricos , Humanos , Masculino , Tratamento Domiciliar/métodos , Tratamento Domiciliar/estatística & dados numéricos , Pessoas Transgênero/estatística & dados numéricos , Resultado do TratamentoRESUMO
In this paper, we describe the implementation of an initiative called "This Is ME," which involves a change in the summary page of a patient's electronic health record in order to include their story and provide a more humanistic perspective. The change includes information related to their family, hobbies and interests - a change that has important implications for facilitating conversation and relationship-building between providers and patients. Since implementation, 1,246 (and counting) patient stories were shared with over 300 healthcare providers, including nurses, social workers, physicians and others. We also share the results of our evaluation of the initiative and provide recommendations for organizations embarking on similar initiatives.
Assuntos
Registros Eletrônicos de Saúde/organização & administração , Assistência Centrada no Paciente/métodos , Atitude do Pessoal de Saúde , Hospitais Psiquiátricos/organização & administração , Humanos , Serviços de Saúde Mental/organização & administração , Ontário , Pacientes/psicologia , Recursos Humanos em HospitalRESUMO
The COVID-19 pandemic has posed unprecedented challenges to the U.S. mental healthcare system. Immediate action has been required to transform existing social work practice models to ensure uninterrupted delivery of essential mental health services. This paper describes how clinicians in a residential program, who offered an in-person multi-family education workshop, rapidly pivoted in the context of the pandemic to develop and implement an alternative and unique multi-family intervention model - a virtual family town hall. This innovative telehealth practice model serves as an exemplar of best practices amidst the COVID-19 pandemic as it prioritized health and safety, increased accessibility, and allowed clinicians to effectively respond to family members' heightened informational needs.
Assuntos
COVID-19/epidemiologia , Família , Educação em Saúde/organização & administração , Serviços de Saúde Mental/organização & administração , Serviço Social/organização & administração , Telemedicina/organização & administração , Comorbidade , Hospitais Psiquiátricos/organização & administração , Humanos , Pandemias , Desenvolvimento de Programas , Avaliação de Programas e Projetos de Saúde , Instituições Residenciais/organização & administração , SARS-CoV-2Assuntos
COVID-19 , Serviços Comunitários de Saúde Mental , Acessibilidade aos Serviços de Saúde , Necessidades e Demandas de Serviços de Saúde/economia , Hospitais de Isolamento/organização & administração , Hospitais Psiquiátricos/organização & administração , COVID-19/epidemiologia , COVID-19/prevenção & controle , COVID-19/psicologia , Gestão de Mudança , Serviços Comunitários de Saúde Mental/organização & administração , Serviços Comunitários de Saúde Mental/normas , Alocação de Recursos para a Atenção à Saúde , Acessibilidade aos Serviços de Saúde/normas , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Humanos , Saúde Mental/economia , Saúde Mental/tendências , SARS-CoV-2 , Uganda/epidemiologiaAssuntos
COVID-19 , Hospitais Psiquiátricos/organização & administração , Controle de Infecções , Transtornos Mentais , Política Organizacional , Visitas a Pacientes , COVID-19/epidemiologia , COVID-19/prevenção & controle , Canadá/epidemiologia , Humanos , Controle de Infecções/métodos , Controle de Infecções/organização & administração , Pacientes Internados/psicologia , Transtornos Mentais/epidemiologia , Transtornos Mentais/psicologia , Transtornos Mentais/terapia , Inovação Organizacional , SARS-CoV-2RESUMO
BACKGROUND: Outbreak is an infection control challenge in health care setting especially when it occurs in a special setting as psychiatric hospitals. Objectives: Investigate and control an outbreak of varicella among patients and healthcare workers (HCWs) in a psychiatric hospital of Saudi Arabia. Methods: A multidisciplinary team of different specialties assigned to assess the situation, confirm the diagnosis, identify the causes and put an action plan to deal with such a situation. Results: The team investigated the varicella outbreak as per the Ministry of Health's (MOH) outbreak guidelines. Multiple risk factors contributed to this outbreak as the location of the outbreak in a psychiatric hospital, breaches in the hospital infection control program. Conclusion: Investigation of this outbreak was conducted as per MOH and CDC definitions and guidelines. Outbreak control plan was instituted and successfully implemented including enforcement of infection control program, the establishment of an employee health program, basic infection control orientation programs.
Assuntos
Pessoal de Saúde/organização & administração , Hospitais Psiquiátricos/organização & administração , Controle de Infecções/organização & administração , Infecção pelo Vírus da Varicela-Zoster/epidemiologia , Surtos de Doenças , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Herpesvirus Humano 3 , Humanos , Masculino , Saúde Ocupacional , Arábia Saudita/epidemiologia , Infecção pelo Vírus da Varicela-Zoster/prevenção & controleRESUMO
This article offers a brief history and the evolution of mental health policy in Turkey. It aims to analyse how mental health policies were transformed and why certain policies were introduced at specific times. The modern history of mental health policy is divided into three periods: the institutionalization of psychiatry and hospital-based mental health services; the introduction of community-based mental healthcare services; and lastly, the policy of deinstitutionalization after the 1980s. These periods have been categorized in a way that basically coincides with Turkey's modern political history.
Assuntos
Política de Saúde/história , Hospitais Psiquiátricos/história , Institucionalização/história , Transtornos Mentais/história , Serviços de Saúde Mental/história , Serviços Comunitários de Saúde Mental/história , Desinstitucionalização/história , História do Século XIX , História do Século XX , História do Século XXI , Hospitais Psiquiátricos/organização & administração , Humanos , Transtornos Mentais/terapia , TurquiaRESUMO
RESUMO Objetivo: este estudo tem como objetivo mapear as evidências científicas disponíveis sobre modelos de gestão de Enfermagem na saúde mental. Método: Scoping Review realizada nas bases de dados MEDLINE via PubMed e CINAHL via EBSCO, no Catálogo de Teses e Dissertações da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), na Biblioteca Digital Brasileira de Teses e Dissertações (BDTD) e na Biblioteca Virtual em Saúde (BVS). Resultados: a amostra final foi de oito estudos e a partir da análise destes construiu-se uma síntese qualitativa dando origem a duas categorias: modelos de gestão aproximados de teorias administrativas tradicionais, normativas e prescritivas; e modelos de gestão aproximados de estilos gerenciais inovadores, participativos e centrados nas pessoas. Conclusão: os modelos identificados se aproximaram de uma gestão voltada para teorias administrativas tradicionais e autocráticas, que privilegiam atividades administrativas e burocráticas, assim como uma liderança autoritária. Constatou-se, no entanto, que as transformações impulsionadas pela Reforma Psiquiátrica no Brasil e no mundo e o redirecionamento do cuidado em saúde mental, com políticas de humanização e valorização do usuário, aceleraram a transição desses modelos para uma gestão mais participativa, com foco no cuidado.
RESUMEN Objetivo: este estudio tiene como objetivo mapear la evidencia científica disponible sobre modelos de gestión de enfermería en salud mental. Método: Scoping Review realizada en bases de datos MEDLINE vía PubMed y CINAHL vía EBSCO, en el Catálogo de Tesis y Disertaciones de la Coordinación para el Perfeccionamiento del Personal de Educación Superior (CAPES), en la Biblioteca Digital Brasileña de Tesis y Disertaciones (BDTD) y en el Biblioteca Virtual de Salud (BVS). Resultados: la muestra final constó de ocho estudios y, a partir de su análisis, se construyó una síntesis cualitativa, dando lugar a dos categorías: modelos de gestión aproximados a las teorías administrativas tradicionales, normativos y prescriptivos; y modelos de gestión aproximados a estilos de gestión innovadores, participativos y centrados en las personas. Conclusión: los modelos identificados se aproximaron de una gestión centrada en las teorías administrativas tradicionales y autocráticas, que privilegian las actividades administrativas y burocráticas, así como un liderazgo autoritario. Sin embargo, se encontró que las transformaciones impulsadas por la Reforma Psiquiátrica en Brasil y en el mundo y la reorientación de la atención en salud mental, con políticas de humanización y mejora del usuario, aceleraron la transición de estos modelos hacia una gestión más participativa, con enfoque en cuidado.
ABSTRACT Objective: the objective of this study was to map the scientific evidence available about Mental Health Nursing management models. Method: a Scoping Review conducted in the MEDLINE and CINHAL databases via PubMed and EBSCO, respectively, in the Theses and Dissertations Catalog of the Coordination for the Improvement of Higher Level Personnel (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, CAPES), in the Brazilian Digital Library of Theses and Dissertations (Biblioteca Digital Brasileira de Teses e Dissertações, BDTD) and in the Virtual Library in Health (Biblioteca Virtual em Saúde, BVS). Results: the final sample consisted of eight studies and, based on the analysis, a qualitative synthesis was prepared, giving rise to two categories: management models approaching traditional, normative and prescriptive administrative theories; and management models approaching innovative, participatory and people-centered management styles. Conclusion: the models identified were approached from a management aimed at traditional and autocratic administrative theories, which privilege administrative and bureaucratic activities, as well as an authoritarian leadership. However, it was found that the transformations driven by the Psychiatric Reform in Brazil and in the world and the retargeting of mental health care, with humanization and user appreciation policies, accelerated the transition of these models to a more participatory management, with a focus on care.