“It’s just all that”: The meanings of suffering in the Family Health Strategy

Abstract

Among the various disputes of perspectives within the scope of the Unified Health System, there is the care for mental health demands and what is meant by them. The objective of this study was to investigate the points of view on suffering through the narratives of users and professionals, seeking to understand how the meaning attributed to the subjects' psychosocial suffering impacts health care in the Family Health Strategy (ESF). A participatory evaluative research was carried out based on the insertion of the main researcher in the field of study, made possible by the internship experience in Primary Care in the city of Rio de Janeiro. Based on a qualitative approach, data triangulation started from participant observation; the field diary; and the meeting minutes book, in which matrix support and team meetings were recorded. The cases covered revealed known anxieties in health services, which, however, find themselves in a social place of delegitimization because they do not correspond to a supposedly objective nosological description. Mediation through diagnosis has become capable of granting social benefits and creating identification bonds. The construction of a social order dependent on biomedical knowledge and the reduction of care to medication prescription are questioned, to the detriment of light care technologies that should be prioritized in Primary Care. Recovering the collective dimension of suffering subverts the use of the health system as an instrument for maintaining inequalities, abandoning decontextualized actions to give space to the integral subject, restored to knowledge about their own pain.