Protocolo de Atención Psicológica Hospitalaria para Crisis de Salud Mental en el Periodo Perinatal

Autores/as

  • Valéria Raquel Alcantara Barbosa Doutora em Saúde Pública pela Escola Nacional de Saúde Pública Sergio Arouca/Fundação Oswaldo Cruz (ENSP/Fiocruz); Psicóloga da Maternidade Dona Evangelina Rosa; Secretaria de Estado da Saúde do Piauí/Associação Reabilitar. https://orcid.org/0000-0002-9281-740X

DOI:

https://doi.org/10.36489/saudecoletiva.2025v15i97p16140-16151

Palabras clave:

Protocolos clínicos, Intervención en la crisis, Atención a la salud mental, Atención perinatal, Maternidades

Resumen

Objetivo: Presentar propuesta de protocolo de atención psicológica a la crisis de salud mental de gestantes y puérperas hospitalizadas. Método: Estudio descriptivo y cualitativo de un protocolo de atención desarrollado como producto del trabajo de la psicóloga en un hospital de maternidad. Resultados: El protocolo consta de nueve etapas: recepción focal de emergencia; llevar a la paciente a un ambiente tranquilo y seguro; escucha activa, atenta y comprensiva; exploración psicológica, valoración psicológica; identificación/adopción de estrategias adaptativas de afrontamiento; no dejar sola a la paciente, intentar mantenerla a salvo hasta que se estabilice; escucha sensible al acompañante/familiar; discusión del caso con el equipo sanitario; registro en la historia clínica electrónica y notificación de la violencia. Conclusión: La atención a la crisis de salud mental en el periodo perinatal requiere: visión caleidoscópica, holística, integral; postura ética-estética-activa-crítica-sensible-empática; legitimar el sufrimiento, la idiosincrasia invisible, una experiencia sui generis, una tríada paciente-equipo-acompañante/familia; coproducción en red.

Citas

Hudson E, Pariseau‐Legault P, Cassivi C, Chouinard C, Goulet M. Mental Health Crisis: An Evolutionary Concept Analysis. International Journal of Mental Health Nursing [Internet]. 2024 Aug 29; Available from: https://doi.org/10.1111/inm.13412

Dias MK, Ferigato SH, Fernandes ADSA. Atenção à crise em saúde mental: centralização e descentralização das práticas. Ciência & Saúde Coletiva [Internet]. 2020 Feb 1;25(2):595–602. Available from: https://doi.org/10.1590/1413-81232020252.09182018

Barbosa VRA. Itinerâncias, fluxos e protocolo de assistência psicológica a gestantes e puérperas internadas em leitos de saúde mental de maternidade de alto risco, em Teresina, Piauí. Observatório de la Economía Latinoamericana [Internet]. 2024 Jan 18;22(1):2251–71. Available from: https://ojs.observatoriolatinoamericano.com/ojs/index.php/olel/article/view/2845

Howard LM, Khalifeh H. Perinatal mental health: a review of progress and challenges. World Psychiatry [Internet]. 2020 Sep 15;19(3):313–27. Available from: https://doi.org/10.1002/wps.20769

Medland V, Nechowska A, Prevezanos P. Perinatal mental health: an overview of pathology, services and the law. The Obstetrician & Gynaecologist [Internet]. 2025 Jan 1;27(1):57–67. Available from: https://doi.org/10.1111/tog.12963

Gimbel LA, Weingarten SJ, Smid MC, Hoffman MC. Maternal mental health as a major contributor to maternal mortality. Seminars in Perinatology [Internet]. 2024 Jul 14;48(6):151943. Available from: https://doi.org/10.1016/j.semperi.2024.151943

Womersley K, Alderson H. Perinatal mental health. Medicine [Internet]. 2024 Aug 26;52(10):632–6. Available from: https://doi.org/10.1016/j.mpmed.2024.07.009

Oladeji B, Oladele O, Gureje O. Mental health: Morbidity and impact. In: Elsevier eBooks [Internet]. 2024. p. 272–86. Available from: https://doi.org/10.1016/b978-0-323-99967-0.00188-5

World Health Organization. WHO guide for integration of perinatal mental health in maternal and child health services [Internet]. www.who.int. 2022. Available from: https://www.who.int/publications/i/item/9789240057142

Bovo PJLB. Padronização para revisão administrativa de protocolos clínicos institucionais de hospital público terciário [dissertation]. Ribeirão Preto: University of São Paulo, Faculdade de Medicina de Ribeirão Preto; 2024. Available from: https://doi.org/10.11606/D.17.2024.tde-26092024-140531

Limone P, Toto GA. Protocols and strategies to use emergency psychology in the face of an emergency: A systematic review. Acta Psychologica [Internet]. 2022 Aug 11;229:103697. Available from: https://doi.org/10.1016/j.actpsy.2022.103697

Garriga M, Pacchiarotti I, Kasper S, Zeller SL, Allen MH, Vázquez G, et al. Assessment and management of agitation in psychiatry: Expert consensus. The World Journal of Biological Psychiatry [Internet]. 2016 Feb 17;17(2):86–128. Available from: https://doi.org/10.3109/15622975.2015.1132007.

Barbosa VRA, Ferreira AFC, Gomes AdS, Nunes Neto J, De Sousa LTM, Sousa MCRG, et al. Avaliação psicológica hospitalar: experiência de parametrização de intervenções assistenciais em Maternidade-Escola de alto risco. Arq Ciênc Saúde Unipar. 2023 Aug 18;27(8):4685-710. Available from: https://revistas.unipar.br/index.php/saude/article/view/10465

Barksdale AN. Perinatal Mental Health Literacy of Healthcare Providers: A Qualitative Phenomenological Study Using an Ecological Systems Theory [Internet]. Scholars Crossing. 2025 Available from: https://digitalcommons.liberty.edu/doctoral/6761

Swift E, Nasir N, Parry K. An individualised approach to the management of pre-existing mental health conditions in pregnancy and puerperium. Obstetrics Gynaecology & Reproductive Medicine [Internet]. 2025 Apr 1; Available from: https://doi.org/10.1016/j.ogrm.2025.03.002

Hung P, Zhang J, Chen S, Harrison SE, Boghossian NS, Li X. A hidden crisis: postpartum readmissions for mental health and substance use disorders in rural and racial minority communities. American Journal of Obstetrics and Gynecology [Internet]. 2024 May 25;231(4):e117–29. Available from: https://doi.org/10.1016/j.ajog.2024.05.047

Atmore KH, Taylor BL, Potts LC, Trevillion K, Howard LM. Caregiving and mental health needs in the significant others of women receiving inpatient and home treatment for acute severe postpartum mental illness. Archives of Women S Mental Health [Internet]. 2022 Dec 24;26(1):49–56. Available from: https://doi.org/10.1007/s00737-022-01286-w

Habersham L, Townsel C, Terplan M, Hurd Y. Substance use and use disorders during pregnancy and the postpartum period. American Journal of Obstetrics and Gynecology [Internet]. 2025 Jan 1; Available from: https://doi.org/10.1016/j.ajog.2025.01.007

King BC, Eastin SM, Ho SY, Shapiro P, Sheen JJ, Fitelson EM. Inpatient obstetric consultation-liaison services: Meeting unmet needs in perinatal mental health. General Hospital Psychiatry [Internet]. 2023 May 1;83:179–84. Available from: https://doi.org/10.1016/j.genhosppsych.2023.04.014

Ether ST, Afrin S, Habib NN, Akter F, Chowdhury AT, Sayeed A, et al. Managing Pre and Postpartum Mental Health Issues of Refugee Women from Fragile and Conflict-Affected Countries: A Systematic Review. Public Health in Practice [Internet]. 2024 Dec 24;9:100573. Available from: https://doi.org/10.1016/j.puhip.2024.100573

Meurk C, Roberts S, Lam M, Wittenhagen L, Callaway L, Moss K, et al. Mental Health profile relating to suicide crises among women in and around pregnancy and surgical termination of pregnancy: a data linkage study. Birth [Internet]. 2025 Mar 28; Available from: https://doi.org/10.1111/birt.12917

Nagle-Yang S, Miles AG, Gores AM, Moses-Kolko E. Preventing perinatal suicide and overdose. Advances in Psychiatry and Behavioral Health [Internet]. 2025 Apr 1; Available from: https://doi.org/10.1016/j.ypsc.2025.02.010

Cook JL, Wilson RD. Providers need guidance on managing perinatal mental health. Canadian Medical Association Journal [Internet]. 2022 Oct 2;194(38):E1328. Available from: https://doi.org/10.1503/cmaj.147105-l

Beyene LS, Strand EB, Misund AR, Barder HE, Brente TL, Størksen HT. Conceptualizing healthcare professionals’ relational competence in mental healthcare: An integrative review. International Journal of Nursing Studies Advances [Internet]. 2024 Nov 8;7:100266. Available from: https://doi.org/10.1016/j.ijnsa.2024.100266

Bina R, Levy D, Alfayumi-Zeadna S, Mesquita ARM, Costa R, Domínguez-Salas S, et al. Changes to social and healthcare providers support in the perinatal period: Impact on coping strategies, depression and anxiety. Midwifery [Internet]. 2025 Jan 14;142:104295. Available from: https://doi.org/10.1016/j.midw.2025.104295

Publicado

2025-07-01

Cómo citar

Barbosa, V. R. A. (2025). Protocolo de Atención Psicológica Hospitalaria para Crisis de Salud Mental en el Periodo Perinatal. Saúde Coletiva (Barueri), 15(97), 16140–16151. https://doi.org/10.36489/saudecoletiva.2025v15i97p16140-16151

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Artículo Original