After the storm: Ruptures and permanencies in the field of mental health after the 2020-2021 biennium

Abstract

The years 2020 and 2021 were marked by important global changes as a result of
the COVID-19 pandemic. In the field of mental health, we have observed an important
increase in research studies and interventions aimed at understanding the repercussions
of the pandemic, in a movement that reveals the fragility of our human condition and, in
addition, the need for us to recognize this circumscriber in search of new ways of existing
and taking care not only of ourselves and others, but of a world in transition.
The transit of the pandemic and its successive waves in all parts of the world reveal
the instability of this historic moment. Thus, the announced end of the 2020-2021 biennium
cannot be embodied, precisely, as the end of a storm, but as a period in which, globally, we had to deal with
the important storms produced by the pandemic at practically all levels of our relationships.
Although we always have a renewed ability to see the future with more hope after the storm, it
is important that we don’t forget what we have gone through – not only for the possibility that these
experiences will be revived in the future, but also because forgetting can cost us a lot. Even in terms of
mental health. It is in this sense that SMAD reinforces every year its commitment to the dissemination of
research studies, interventions and reflections in the field of mental health engaged not only in change, but
anchoring itself in the need to remember our past, being able to build a reflective future and, especially,
more human in this field of care.
The first issue of SMAD in 2022 opens with a very timely editorial on Science communication and its
role in a society dominated by information, written by Prof. Dr. Carolina Aires, from the Ribeirão Preto School
of Pharmaceutical Sciences, University of São Paulo. The text highlights the importance that researchers
attribute to fighting against fake news and to the construction of information networks which stand up
against the vertiginous dissemination of inappropriate content that puts the health of the population at
risk(1). In the field of mental health, fake news can contribute to the reinforcement of stigmas, proliferation of misinformation about treatments and, therefore, expose a large percentage of people to ineffective treatments
or even undervalue expressions of mental illness in everyday life.
The first article that comprises this issue is entitled “Deinstitutionalization and the new possibilities in the
daily lives of family members of graduates of a psychiatric hospital”, by Ingredy Nayara Chiaccio Silva and
Carina Pimentel Souza Batista, from the Federal University of Bahia. Based on interviews with family members of
psychiatric hospital leavers, repercussions such as fear and apprehension for the process of deinstitutionalization
are highlighted. The research emphasizes the importance of the work of the deinstitutionalization team in the
process of rebuilding affective bonds with these family members, emphasizing that this is still one of the biggest
challenges of assistance in line with the ruptures promoted by the Psychiatric Reform.
The second article is entitled “Councilmen’s knowledge about the use of alcohol and repercussions on the users’
health”, by Tancredo Castelo Branco Neto and other researchers, in a collaboration initiative between the Federal
University of Amapá, the Federal University of Piauí and the UNINOVAFAPI University Center. Most of the councilors
interviewed disapproved the use of alcohol by the population, resorting to ideas based on common sense to deal
with the possible health problems arising from alcohol use and abuse. The study points to the need for greater
awareness of these legislators related to public health issues, especially the legal guardianship of alcohol users.
Next, Jorge Luiz Lima da Silva and collaborators linked to the Fluminense Federal University present the study
entitled “Common mental disorders and Burnout syndrome among university professionals”. The research was
carried out with 106 education workers, revealing that the suspicion of common mental disorder in this sample
was 22.6%, with associations between the depersonalization and emotional exhaustion dimensions that are
characteristic of burnout. Addresses in relation to the prevention of health problems in this context are presented
by the authors.
Next, the study entitled “Potentialities and challenges of multidisciplinary work in the Psychosocial Care Centers”,
by Giovana Telles Jafelice, Daniel Augusto da Silva and João Fernando Marcolan, from the Federal University of São
Paulo, is presented. The research interviewed 27 workers from nine Psychosocial Care Centers for Adults linked to
the Municipality of São Paulo. Among the potentialities of this action, the possibility of integrated and networked
work was highlighted. Precariousness of work and the worker’s distress were mentioned as limitations. These
limitations are narrated by the workers in reference to what they call the outpatient logic, revealing weaknesses
in the implementation of the Psychiatric Reform’s assumptions.
Researchers at the UNIFACISA University Center and the State University of Paraíba then present the article
entitled “State-trait anxiety in university students of the Nursing course”. As noted in the scientific literature
investigating mental health in higher education students(2), the authors found a high anxiety level in the sample.
In the study in question, this anxiety is associated with academic situations and with the consequences of this
routine, which should also be discussed based on educational policies willing to understand the role of this context
in this symptomatology.
The methodological study entitled “Development of a health literacy assessment instrument related to
drinking habit”, by Ana Monique Gomes Brito and collaborators from the United Colleges of Northern Minas and
the State University of Montes Claros, investigated the properties of the instrument for the assessment of Literacy
in Health regarding the Drinking Habit (LHDH). Based on the psychometric properties presented and discussed in
the article, LHDH was considered valid, reliable and with good interpretability, with the possibility of giving rise
to other methodological studies for a more detailed understanding of these properties.
Subsequently, Aline Bedin Zanatta, Laura Lamas Martins Gonçalves and Sergio Roberto de Lucca, from the
State University of Campinas, present the article entitled The work process in psychosocial care centers from a
management perspective. Managers of 11 Psychosocial Care Centers from a large city in the inland of São Paulo
were interviewed. The managers highlight job satisfaction in terms of the possibility of close attention and with
mental health links. Despite this, they also reveal situations of wear out in relation to the nature of the work and
its administrative processes. The authors recommend strengthening the network as an important promoter of
care among the multidisciplinary team.
The study entitled “Self-medication with psychotropic drugs among university students: An integrative review”
is presented by researchers from the Franciscana University, Santa Maria, state of Rio Grande do Sul. The review
included publications between 2009 and 2019, corroborating the vulnerability of university students regarding the
risks of self-medication, especially in relation to the use of stimulants and analgesics. The motivations for selfmedication
involve academic performance factors. The authors emphasize the urgency of “sensitizing authorities regarding the legitimization and implementation of public policies to fight against self-medication among university
students”.
The issue ends with the article entitled “Photography in mental health: a look at the subjective”, by Lahanna
da Silva Ribeiro and collaborators linked to the Porto Alegre Federal University of Health Sciences. The integrative
review sought to identify actions in mental health based on photography in the scientific literature. The studies
retrieved reveal actions such as workshops and research studies on photo-voice and photo-elicitation, in addition
to photographic exhibitions. The authors concluded that photography can be a “mental health promotion device
by allowing individuals to share their experiences and feelings, which are commonly concealed in conventional
methodologies”.
We end this presentation with the hope that these studies from the first 2022 issue can be appreciated as
invitations to two important movements. The first of them refers to the need to research and intervene with the
professionals who work in mental health devices, such as the interest expressed in relation to health professionals
of the so-called “front line” in the fight against COVID-19(3), as well as with university students(2). The demands of
these groups have been revealed in the scientific literature not only as expressive and urgent, but also allowing
for reflections in relation to the University we have been building over the last few years and on the real changes
from the Psychiatric Reform, specifically with regard to these professionals from different categories in the various
mental health care facilities.
Also in this first movement, to these two prioritized audiences in the field of mental health, as illustrated in this
issue that opens the year 2022, we can add the teachers(4) – from kindergarten to higher education – especially
considering the transitions between face-to-face, remote and hybrid teaching made possible in the pandemic
itinerary. Obviously, mental health vulnerabilities continue to mobilize research and intervention efforts, which
should be addressed, more clearly, in studies based on the greatest storm experienced precisely in the years
2020 and 2021.
Considering these vulnerabilities also involves comparing the diversities, the increase in poverty and extreme
poverty in the Brazilian setting, for example, in addition to the social, economic, political and cultural asymmetries
that do not allow us to assert that we are facing the same storm(5). Therefore, it is essential to prioritize the care
of populations in permanent vulnerability, in a storm that does not extinguish with the announcement of the end
of a period. Looking at this process from white-skinned-American-Eurocentered perspectives that are not very
porous to otherness will continue to revive the storm we are trying to overcome.
The second movement legitimized by these productions involves the need for the realities herein portrayed,
notably produced before the COVID-19 pandemic context, to be accompanied in terms of changes, needs and
limitations imposed by this global context. The year 2022 is ahead as an important marker after two years of
intense transformations. It is not necessarily about considering this year as a post-pandemic context but, rather,
as a year in which different invitations can be addressed: permanence of the challenges imposed in the 2020-
2021 biennium and elaboration of new strategies for the resumption of what we once were and, more probably,
for the creation of what we need to be after this storm. And, finally, in a scenario of impermanence, the question
remains clear: Did we make it through the storm?