Determinação social da saúde e sofrimento psíquico: reflexões a partir de uma comunidade quilombola

Abstract

The present study aims to analyze psychological distress based on Social Determination in Health in a quilombo in Minas Gerais. The methodology used included the steps of approaching, establishing links, agreeing on the research with the community, and collecting data. The Participant Observation technique recorded through the Field Diary was carried out throughout the process. Thus, 69 quilombo residents were interviewed, totaling 48 families. The following instruments were used: a Sociodemographic Questionnaire, an adapted version of the SRQ (Self-Reporting Questionnaire) containing 14 questions, the AUDIT (Alcohol Use Disorder Identification Test), and a Pharmacotherapeutic Profile Questionnaire. The 15 participants who scored above the cutoff established in the SRQ-14 were invited to participate in an interview. To obtain descriptive data, the collected material was processed using the Statistical Package for the Social Sciences (SPSS) software. The qualitative content of the interviews was analyzed using Thematic-Categorical Content Analysis. The results confirm the inequalities experienced by this population, such as lower income levels, low educational achievements, multiple jobs, precarious state of agricultural work, and the fragility of basic sanitation and infrastructure conditions. The psychological suffering that emerges from individual experiences of loss, grief, financial instability, family conflicts, domestic violence, and the weakening of community ties is interpreted in light of the particularities of the Brazilian Social Question, including racism, patriarchy, labor overexploitation, and land concentration. The therapeutic paths followed in the search for mental health care expose the challenges faced by the Unified Health System (SUS) and the Psychosocial Care Network (RAPS) in consolidating the right to health in the face of conflicts with capitalist social organization and the commodification of life. The Family Health Strategy stands out as the main means of access to health care for the community in the face of existing barriers. However, the care resources offered have proven to be restricted and limited to individual and biomedical practices, such as consultations and the prescription of psychotropic drugs. The community's alternative strategies include work activities related to the land, religious experience, and the community support network. It is therefore concluded that the analysis of psychological distress based on the Social Determination of Health makes explicit the structural and ideological nature behind the maintenance of the inequalities experienced by the Quilombolas, as well as pointing to the need for political organization to effectively.