Publication Cover
Global Public Health
An International Journal for Research, Policy and Practice
Volume 18, 2023 - Issue 1
1,548
Views
3
CrossRef citations to date
0
Altmetric
Structural Competency in Global Perspective

Rethinking structural competency: Continuing education in mental health and practices of territorialisation in Brazil

ORCID Icon & ORCID Icon
Article: 2157034 | Received 27 May 2022, Accepted 01 Dec 2022, Published online: 19 Dec 2022

References

  • Amarante, P. (2000). Loucos pela Vida: A trajetória da reforma psiquiátrica no Brasil (2nd ed.). Fiocruz.
  • Batista, K. B. C., & Gonçalves, O. S. J. (2011). Formação dos profissionais de saúde para o SUS: significado e cuidado. Saúde e Sociedade, 20(4), 884–899. https://doi.org/10.1590/S0104-12902011000400007
  • Béhague, D., & Ortega, F. (2021). Mutual aid, pandemic politics, and global social medicine in Brazil. The Lancet, 398(10300), 575–576. https://doi.org/10.1016/S0140-6736(21)01002-3
  • Bernardino-Costa, J., & Blackman, A. E. C. (2017). Affirmative action in Brazil and building an anti-racist university. Race Ethnicity and Education, 20(3), 372–384. https://doi.org/10.1080/13613324.2016.1260228
  • Borghi, C. M. S. O., de Oliveira, R. M., & Sevalho, G. (2018). Determinação ou determinantes sociais da saúde: texto e contexto na américa latina. Trabalho, Educação e Saúde, 16(3), 869–897. https://doi.org/10.1590/1981-7746-sol00142
  • Bourgois, P., Holmes, S. M., Sue, K., & Quesada, J. (2017). Structural vulnerability: Operationalizing the concept to address health disparities in clinical care. Academic Medicine, 92(3), 299–307. https://doi.org/10.1097/ACM.0000000000001294. PMID: 27415443; PMCID: PMC5233668
  • Brasil. (2007). Ministério da Saúde. Portaria n.o 1996/GM/ MS, de 20 de agosto de 2007. Dispõe sobre as diretrizes para a implementação da política nacional de educação Permanente em Saúde e dá outras providências. Ministério da Saúde.
  • Chazan, L. F., Fortes, S., & CamargoJrK. R. (2020). Apoio Matricial em Saúde Mental: revisão narrativa do uso dos conceitos horizontalidade e supervisão e suas implicações nas práticas. Ciência & Saúde Coletiva, 25(8), 3251–3260. https://doi.org/10.1590/1413-81232020258.31942018
  • Coimbra, C. E., Santos, R. V., Welch, J. R., Cardoso, A. M., de Souza, M. C., Garnelo, L., & Horta, B. L. (2013). The first national survey of indigenous people's health and nutrition in Brazil: Rationale, methodology, and overview of results. BMC Public Health, 13(1), Article 52. https://doi.org/10.1186/1471-2458-13-52
  • da Saúde, M. (2004). Legislação em Saúde Mental−1990-2004 (5th ed.). Editora do Ministério da Saúde.
  • da Silva, A. J. B., & Larkins, E. R. (2019). The bolsonaro election, antiblackness, and changing race relations in Brazil. The Journal of Latin American and Caribbean Anthropology, 24(4), 893–913. https://doi.org/10.1111/jlca.12438
  • Desviat, M. (2016). Cohabitar la diferencia: De la reforma psiquiátrica a la salud mental colectiva. Editorial Grupo 5.
  • Dimenstein, M., Siqueira, K., Macedo, J. P., Leite, J., & Dantas, C. (2017). Determinação social da saúde mental: Contribuições à psicologia no cuidado territorial. Arquivos Brasileiros de Psicologia, 69(2), 72–87. http://pepsic.bvsalud.org/scielo.php?script=sci_arttext&pid=S1809-52672017000200006&lng=pt&tlng=pt.
  • Faria, D. S., Ferreira Neto, J. L., Silva, K. L., & Modena, C. M. (2021). Educação Permanente em Saúde: narrativa dos trabalhadores de Saúde Mental de Betim/Minas Gerais. Physis: Revista de Saúde Coletiva, 31(2), Article e310202. https://doi.org/10.1590/s0103-73312021310202
  • Farmer, P. (2004). An anthropology of structural violence. Current Anthropology, 45(3), 305–325. https://doi.org/10.1086/382250
  • Fleckman, J. M., Dal Corso, M., Ramirez, S., Begalieva, M., & Johnson, C. C. (2015). Intercultural competency in public health: A call for action to incorporate training into public health education. Frontiers in Public Health, 3, Article 210. https://doi.org/10.3389/fpubh.2015.00210
  • Flick, U. (2000). Episodic interviewing. In M. Bauer, & G. Gaskell (Eds.), Qualitative researching with text, image and sound: A practical handbook (pp. 75–82). Sage.
  • Fonseca, S. (2020). Latin American social medicine. The making of a thought style [Unpublished doctoral dissertation]. King’s College, London. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.822303
  • Foot, J. (2015). The man who closed the asylums: Franco Basaglia and the revolution in mental health care. Verso.
  • França, T., Pierantoni, C., Belisario, S., Medeiros, K., Castro, J., Cardoso, I., & Garcia, A. (2016). A capilaridade da Política Nacional de Educação Permanente em Saúde no Brasil. Atas CIAIQ, 2016, 2. https://proceedings.ciaiq.org/index.php/ciaiq2016/article/view/738/725
  • Furtado, J. P., Oda, W. Y., Borysow, I. D. C., & Kapp, S. (2016). The concept of territory in mental health. Cadernos de Saúde Pública, 32(9), Article e00059116. https://doi.org/10.1590/0102-311x00059116
  • Gajaria, A., Izenberg, J. M., Nguyen, V., Rimal, P., Acharya, B., & Hansen, H. (2019). Moving the global mental health debate forward: How a structural competency framework can apply to global mental health training. Academic Psychiatry, 43(6), 617–620. https://doi.org/10.1007/s40596-019-01073-3
  • Gigante, R. L., & Campos, G. W. D. S. (2016). Política de formação e educação permanente em saúde no Brasil: bases legais e referências teóricas. Trabalho, Educação e Saúde, 14(3), 747–763. https://doi.org/10.1590/1981-7746-sip00124
  • Greene, S. (2008). The Shaman's needle: Development, Shamanic Agency, and intermedicality in Aguaruna Lands, Peru. American Ethnologist, 25(4), 634–658. https://doi.org/10.1525/ae.1998.25.4.634
  • Harvey, M., Piñones-Rivera, C., & Holmes, S. M. (2022). Thinking with and against the social determinants of health: The Latin American Social Medicine (Collective Health) Critique from Jaime Breilh. International Journal of Health Services, 52(4), 433–441. https://doi.org/10.1177/00207314221122657
  • Kinker, F. S., Moreira, M. I. B., & Bertuol, C. (2018). O desafio da formação permanente no fortalecimento das Redes de Atenção Psicossocial. Interface - Comunicação, Saúde, Educação, 22(67), 1247–1256. https://doi.org/10.1590/1807-57622017.0493
  • Kirmayer, L. (2012). Rethinking cultural competence. Transcultural Psychiatry, 49(2), 149–164. https://doi.org/10.1177/1363461512444673
  • Kleinman, A., & Benson, P. (2006). Anthropology in the clinic: The problem of cultural competency and how to fix it. PLoS Medicine, 3(10), Article e294. https://doi.org/10.1371/journal.pmed.0030294
  • Krieger, N. (2003). Latin American social medicine: The quest for social justice and public health. American Journal of Public Health, 93(12), 1989–1991. https://doi.org/10.2105/AJPH.93.12.1989
  • Langdon, E. J. (2014). Os diálogos da antropologia com a saúde: Contribuições para as políticas públicas. Ciência & Saúde Coletiva, 19(4), 1019–1029. https://doi.org/10.1590/1413-81232014194.22302013
  • Layton, M., & Smith, A. (2017). Is it race, class, or gender? The sources of perceived discrimination in Brazil. Latin American Politics and Society, 59(1), 52–73. https://doi.org/10.1111/laps.12010
  • Lekas, H.-M., Pahl, K., & Fuller-Lewis, C. (2020). Rethinking cultural competence: Shifting to cultural humility. Health Services Insights, 13. https://doi.org/10.1177/1178632920970580
  • Lima, N. T., Edler, F., Gerschman, S., & Suárez, J. M. (2005). Saúde e Democracia: História e Perspectivas do SUS. Fiocruz.
  • Martinez-Hernaez, A., Bekele, D., Sabariego, C., Rodríguez-Laso, Á, Vorstenbosch, E., Rico-Uribe, L. A., Ayuso-Mateos, J. L., Sánchez-Niubò, A., Rodríguez-Mañas, L., & Haro, J. M. (2021). The Structural and Intercultural Competence for Epidemiological Studies (SICES) guidelines: A 22-item checklist. BMJ Global Health, 6(4), Article e005237. https://doi.org/10.1136/bmjgh-2021-005237
  • Martins-Filho, P. R., Araújo, B. C. L., Sposato, K. B., Araújo, A. A. S., Quintans-Júnior, L. J., & Santos, V. S. (2021). Racial disparities in COVID-19-related deaths in Brazil: Black lives matter. Journal of Epidemiology, 31(3), 239–240. https://doi.org/10.2188/jea.JE20200589
  • Menéndez, E. L. (2016). Intercultural health: Proposals, actions and failures. Ciência & Saúde Coletiva, 21(1), 109–118. https://doi.org/10.1590/1413-81232015211.20252015
  • Menezes, A. L. A., Muller, M. R., Soares, T. R. A., Figueiredo, A. P., Correia, C. R. M., Corrêa, L. M., & Ortega, F. (2018). Parallels between research in mental health in Brazil and in the field of global mental health: An integrative literature review. Cadernos de Saúde Pública, 34(11), Article e00158017. https://doi.org/10.1590/0102-311X00158017
  • Metzl, J. M., & Hansen, H. (2014). Structural competency: Theorizing a new medical engagement with stigma and inequality. Social Science & Medicine, 103, 126–133. https://doi.org/10.1016/j.socscimed.2013.06.032
  • Metzl, J. M., & Roberts, D. E. (2014). Structural competency meets structural racism: Race, politics, and the structure of medical knowledge. The Virtual Mentor, 16(9), 674–690. https://doi.org/10.1001/virtualmentor.2014.16.09.spec1-1409. PMID: 25216304
  • Morales, C., Borde, E., Eslava, J. C., & Concha-Sanchez, S. (2013). ¿Determinación social o determinantes sociales? Diferencias conceptuales e implicaciones praxiologicas. Revista De Salud Publica, 15(6), 797–808. https://www.proquest.com/scholarly-journals/determinacion-social-o-determinantessociales/docview/1677206554/se-2
  • Müller, M. R. (2019). Competência cultural no matriciamento em saúde mental [Unpublished doctoral dissertation]. State University of Rio de Janeiro, Rio de Janeiro. https://www.bdtd.uerj.br:8443/handle/1/3956
  • Neff, J., Holmes, S. M., Knight, K. R., Strong, S., Thompson-Lastad, A., McGuinness, C., Duncan, L., Saxena, N., Harvey, M. J., Langford, A., Carey-Simms, K. L., Minahan, S. N., Satterwhite, S., Ruppel, C., Lee, S., Walkover, L., De Avila, J., Lewis, B., Matthews, J., & Nelson, N. (2019). The structural competency working group: Lessons from iterative, interdisciplinary development of a structural competency training module. In H. Hansen, & J. Metzl (Eds.), Structural competency in mental health and medicine (pp. 53–74). Springer.
  • Neff, J., Holmes, S. M., Knight, K. R., Strong, S., Thompson-Lastad, A., McGuinness, C., Duncan, L., Saxena, N., Harvey, M. J., Langford, A., Carey-Simms, K. L., Minahan, S. N., Satterwhite, S., Ruppel, C., Lee, S., Walkover, L., De Avila, J., Lewis, B., Matthews, J., & Nelson, N. (2020). Structural competency: Curriculum for medical students, residents, and interprofessional teams on the structural factors that produce health disparities. MedEdPORTAL: The Journal of Teaching and Learning Resources, 16, Article 10888. https://doi.org/10.15766/mep_2374-8265.10888
  • Neff, J., Knight, K. R., Satterwhite, S., Nelson, N., Matthews, J., & Holmes, S. M. (2017). Teaching structure: A qualitative evaluation of a structural competency training for resident physicians. Journal of General Internal Medicine, 32(4), 430–433. https://doi.org/10.1007/s11606-016-3924-7
  • Ortega, F., & Wenceslau, L. D. (2020). Challenges for implementing a global mental health agenda in Brazil: The “silencing” of culture. Transcultural Psychiatry, 57(1), 57–70. https://doi.org/10.1177/1363461518824433
  • Ortega, F., & Wenceslau, L. D. (2021). Culture and mental health in Brazil. In R. Moodley, & E. Lee (Eds.), The Routledge international handbook of race, ethnicity, and culture in mental health (pp. 341–352). Routledge.
  • Paim, J., Travassos, C., Almeida, C., Bahia, L., & Macinko, J. (2011). The Brazilian health system: History, advances, and challenges. The Lancet, 377(9779), 1778–1797. https://doi.org/10.1016/S0140-6736(11)60054-8
  • Perry, K.-K. Y. (2020). The resurgent far right and the black feminist struggle for social democracy in Brazil. American Anthropologist, 122(1), 157–162. https://doi.org/10.1111/aman.13358
  • Popadiuk, G. S., Oliveira, D. C., & Signorelli, M. C. (2017). The national policy for comprehensive health of lesbians, gays, bisexuals and transgender (LGBT) and access to the sex reassignment process in the Brazilian unified health system (SUS): progress and challenges. Ciência & Saúde Coletiva, 22(5), 1509–1520. https://doi.org/10.1590/1413-81232017225.32782016
  • Porter, D. (2006). How did social medicine evolve, and where is it heading? PLoS Medicine, 3(10), e399. https://doi.org/10.1371/journal.pmed.0030399
  • Ribeiro, D. (2000). The Brazilian people: The formation and meaning of Brazil. University Press of Florida.
  • Robcis, C. (2021). Disalienation: Politics, philosophy, and radical psychiatry in postwar France. The University of Chicago Press.
  • Santos, T., Oliveira, J., Azevedo, R., & Penido, C. (2021). O caráter técnico-pedagógico do apoio matricial: Uma revisão bibliográfica exploratória. Physis: Revista de Saúde Coletiva, 31(3), Article e310316. https://doi.org/10.1590/s0103-73312021310316
  • Saraiva, S. A. L., Zepeda, J., & Liria, A. F. (2020). Components of matrix support and collaborative mental health care: A narrative review. Ciência & Saúde Coletiva, 25(2), 553–565. https://doi.org/10.1590/1413-81232020252.10092018
  • Scafuto, J. C. B., Saraceno, B., & Delgado, P. G. G. (2017). Formação e educação permanente em saúde mental na perspectiva da desinstitucionalização (2003-2015). Comunicação em Ciências da Saúde, 28(03/04), 350–358. https://doi.org/10.51723/ccs.v28i03/04.277
  • Serrão, R. (2020). Racializing region: Internal orientalism, social media, and the perpetuation of stereotypes and prejudice against Brazilian nordestinos. Latin American Perspectives, 49(5), 181–199. https://doi.org/10.1177/0094582X20943157
  • Silva, K. L. D., França, B. D., Marques, R. D. C., & Matos, J. A. V. D. (2019). Análise dos discursos referentes à educação permanente em saúde no Brasil (1970 a 2005). Trabalho, Educação e Saúde, 17(2), Article e0019222. https://doi.org/10.1590/1981-7746-sol00192
  • Silveira, J. L. G. C. D., Kremer, M. M., Silveira, M. E. U. C. D., & Schneider, A. C. T. D. C. (2020). Percepções da integração ensino-serviço-comunidade: Contribuições para a formação e o cuidado integral em saúde. Interface - Comunicação, Saúde, Educação, 24, Article e190499. https://doi.org/10.1590/interface.190499
  • Souto, K. M. B., Sena, A. G. N., Pereira, V. O. d. M., & Santos, L. M. d. (2016). State and equity policies in health: Participatory democracy? Saúde em Debate, 40, 49–62. https://doi.org/10.1590/0103-11042016s05
  • Stonington, S. D., Holmes, S. M., Hansen, H., Greene, J. A., Wailoo, K. A., Malina, D., Morrissey, S., Farmer, P. E., & Marmot, M. G. (2018). Case studies in social medicine – attending to structural forces in clinical practice. New England Journal of Medicine, 379(20), 1958–1961. https://doi.org/10.1056/NEJMms1814262
  • Targa, L. V., & Oliveira, F. A. (2012). Cultura, saúde e o médico de família. In G. Gusso, & J. M. C. Lopes (Eds.), Tratado de medicina de família e comunidade – princípios, formação e prática (pp. 74–80). Artmed.
  • Taylor, J. S. (2003). Confronting “culture” in medicine's “culture of no culture”. Academic Medicine, 78(6), 555–559. https://doi.org/10.1097/00001888-200306000-00003
  • Vasconcelos, E. M. (2008). Abordagens Psicossociais volume II: Reforma psiquiátrica e saúde mental na ótica da cultura e das lutas populares. Hucitec.
  • Vieira-da-Silva, L. M. (2021). Collective health: Theory and practice. Innovations from Latin America. In Oxford research encyclopedias - global public health. Oxford University Press.
  • Wacquant, L. (2007). Territorial Stigmatization in the Age of Advanced Marginality. Thesis Eleven, 91(1), 66-77.
  • Waitzkin, H., Iriart, C., Estrada, A., & Lamadrid, S. (2001). Social medicine then and now: lessons from Latin America. American journal of public health, 91(10), 1592–1601. https://doi.org/10.2105/ajph.91.10.1592
  • Werneck, J. (2016). Racismo institucional e saúde da população negra. Saúde e Sociedade, 25(3), 535–549. https://doi.org/10.1590/s0104-129020162610
  • Yasui, S., Luzio, C. A., & Amarante, P. (2016). From manicomial logic to territorial logic: Impasses and challenges of psychosocial care. Journal of Health Psychology, 21(3), 400–408. https://doi.org/10.1177/1359105316628754