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Barreiras no acesso aos serviços de saúde mental em Portugal : a influência do desemprego e da sintomatologia depressiva
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Abstract(s)
A presente investigação teve como intuito compreender que barreiras no acesso aos cuidados de saúde mental são identificadas por pessoas em situação de desemprego; a relação entre as barreiras percebidas no acesso aos cuidados e a sintomatologia depressiva; e sugerir melhorias para o acesso aos cuidados de saúde mental desta população em Portugal. Este estudo seguiu um design misto convergente, combinando dados de um questionário aplicado a sujeitos desempregados e entrevistas realizadas a profissionais da área da saúde mental e social. Obtiveram-se 93 respostas ao questionário (das quais 68 totalmente preenchidas), que incluiu uma caracterização sociodemográfica, uma escala padronizada de sintomas depressivos (Beck-Depression Inventory-II (BDI-II)) e uma escala para identificar barreiras no acesso aos cuidados de saúde mental (Barriers to Accessing Care Evaluation-3 (BACE-3)), analisados descritiva e inferencialmente, com recurso ao software IBM SPSS (versão 30). Paralelamente efetuaram-se 10 entrevistas semiestruturadas, que foram gravadas e transcritas. Para a análise de conteúdo das entrevistas recorreu-se ao software NVIVO 14. Os resultados sugerem que as barreiras no acesso aos cuidados de saúde mental identificadas pelos sujeitos desempregados associam-se com a sintomatologia depressiva, observando-se uma correlação positiva entre a pontuação no BACE-3 e a pontuação no BDI-II (r= 0,523; p = 0.000), reforçada pela regressão linear múltipla estimada, onde a associação com o BACE-3 se manteve estatisticamente significativa (B=11,17; Erro Padrão, EP=2,6317, p
The aim of this research was to understand the barriers to access to mental health care for unemployed people; the relationship between these perceived barriers and depressive symptoms; and to suggest improvements to access to mental health care for this population in Portugal. This study followed a convergent mixed design, combining data from a questionnaire applied to unemployed subjects and interviews carried out with mental health and social professionals. There were 93 responses to the questionnaire, (68 of which were fully completed) which included a sociodemographic characterization, a standardized scale of depressive symptoms (Beck-Depression Inventory-II (BDI-II)) and a scale to identify barriers to accessing mental health care (Barriers to Accessing Care Evaluation-3 (BACE-3)), which were analyzed descriptively and inferentially using IBM SPSS software (version 30). At the same time, 10 semi-structured interviews were carried out, recorded and transcribed. NVIVO 14 software was used to analyze the content of the interviews. The results suggest that the barriers to accessing mental health care identified by unemployed subjects are associated with depressive symptomatology: a positive correlation was observed between the BACE-3 score and the BDI-II score (r= 0.523; p = 0. 000), reinforced by the estimated multiple linear regression, where the association with BACE-3 remained statistically significant (B=11.17; Standard Error, SE=2.6317, p<0.001), independently of sociodemographic characteristics (gender, marital status, education, health status). In the qualitative component, it was suggested that there should be more family doctors, psychologists and psychiatrists in health centers, that care should be more decentralized and that social services should be more proactive. Greater investment in the mental health service is therefore essential, given the impact unemployment can have on individuals' mental health.
The aim of this research was to understand the barriers to access to mental health care for unemployed people; the relationship between these perceived barriers and depressive symptoms; and to suggest improvements to access to mental health care for this population in Portugal. This study followed a convergent mixed design, combining data from a questionnaire applied to unemployed subjects and interviews carried out with mental health and social professionals. There were 93 responses to the questionnaire, (68 of which were fully completed) which included a sociodemographic characterization, a standardized scale of depressive symptoms (Beck-Depression Inventory-II (BDI-II)) and a scale to identify barriers to accessing mental health care (Barriers to Accessing Care Evaluation-3 (BACE-3)), which were analyzed descriptively and inferentially using IBM SPSS software (version 30). At the same time, 10 semi-structured interviews were carried out, recorded and transcribed. NVIVO 14 software was used to analyze the content of the interviews. The results suggest that the barriers to accessing mental health care identified by unemployed subjects are associated with depressive symptomatology: a positive correlation was observed between the BACE-3 score and the BDI-II score (r= 0.523; p = 0. 000), reinforced by the estimated multiple linear regression, where the association with BACE-3 remained statistically significant (B=11.17; Standard Error, SE=2.6317, p<0.001), independently of sociodemographic characteristics (gender, marital status, education, health status). In the qualitative component, it was suggested that there should be more family doctors, psychologists and psychiatrists in health centers, that care should be more decentralized and that social services should be more proactive. Greater investment in the mental health service is therefore essential, given the impact unemployment can have on individuals' mental health.
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Keywords
Desemprego Cuidados de saúde mental Depressão Barreiras no acesso a cuidados de saúde mental Unemployment Depression Barriers to access mental health care Mental health care
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