Dinâmica familiar de pessoas com comportamento suicida: aplicação do modelo Calgary de Avaliação

Abstract

The high rates and repercussions of suicidal behavior make the phenomenon a serious public health problem, which requires coping prevention strategies. Considering the importance of the family as a component of social support, there is an urgent need to understand the dynamics of family relationships in the context of suicidal ideation. Thus, this thesis addresses the following chapters to compose the history of art: I- Suicidal behavior: from historical roots to the rhizome of contemporaneity (Suicidal behavior: a web of complexus; -Global overview of suicidal behavior as a public health problem: Epidemic silent?); II-From the parts to the whole: the family as a (non)functional system (Psychiatric reform and family: visibility and participation of the family system of the person with psychological distress; Family and suicidal behavior) and III-The covid-19 pandemic and psychic suffering. To understand the family dynamics of people with suicidal behavior. This is a study with a qualitative approach, based on the theoretical-methodological framework of the Calgary Family Assessment Model (MCAF), which refers to a family assessment model that encompasses the structure, development and functionality of the family system. Regarding the place of study, this was developed at the Nucleus for the Study and Prevention of Suicide (NEPS), an outpatient service specialized in caring for people with suicidal behavior in the state of Bahia. With regard to the study participants, there were 07 families and 09 family members of patients with suicidal behavior followed at NEPS. Inclusion criteria were as follows: spouses, consanguineous relatives or family members with affection ties of users in regular follow-up at NEPS; be aged 18 years and/or older and be in an emotional and cognitive condition. In the first stage of the study, in a virtual meeting with the users, to get to know their family members beforehand, the genogram and ecomap were constructed. The first is a family tree that includes additional information about relationships between people, while the ecomap, a complement to the genogram, consists of a graphic representation of the relationships and contacts between family members, the community, health services and other institutions, allowing assess their networks and social supports. For this construction, GenoPro® software was used, developed by GenoPro SDK with the objective of helping data storage, construction and presentation of family genealogies. Four manuscripts emerged from this thesis, namely: Structural assessment in families of people with suicidal behavior: Application of the Calgary Model; Developmental assessment in families of people with suicidal behavior: Application of the Calgary Model; Functional assessment in families of people with suicidal behavior: Application of the Calgary Model and Expressions of care in the family dynamics of people with suicidal behavior. Thus, the discussion revolved around the structure of generations of people with suicidal behavior, which is marked over time by stories and adverse life events. The reports of relatives of people with suicidal behavior that also showed that the events that took place in the family nucleus, profoundly marked the stages of the family's life cycle. In addition, the results revealed how intense and diverse the functionality of each family nucleus is. This is because there are many ways that each one finds to remain structured and resilient despite the obstacles encountered, including psychological illness and the suicidal behavior of one of its members. Elucidating the structure, development and functionality of families of people with suicidal behavior makes it possible to bond, understand and intervene in conflicts, (dis)harmony and disarrangement of the family nucleus.This is because with the application of the Calgary Model for the Evaluation of families of people with suicidal behavior, it allows the professional to organize and improve the care and follow-up of this family, as well as to use all these tools as protective factors for suicide attempts. Going further, it is important to point out that the cyclic action of suicide prevention is also a way to reduce illness, stress and strain in the family nucleus. Thus, with this study, the MCAF of families of people with suicidal behavior is registered, opening paths and spaces for studies with the application of the Calgary Intervention Model. In this way, this movement can make the family act in a positive and resilient way and act as the main support in the lives of people with suicidal behavior