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Primary care, psychosocial care and complementary and alternative medicine: elective affinities

This article discusses the elective affinities between three phenomena in health: primary health care, the psychosocial approach to mental health care and the progressive use of complementary and integrative practices. Despite the differences between the three movements, they converge in their critique and answers to problems arising from the hegemonic biomedical care. Although regulated and under implementation in the National Health System (the complementary and integrative practices still in an incipient form), these phenomena bear a counter-hegemonic character. Their concepts of object, means and objectives of work or care have relevant affinities, such as focus on the subjects in their social contexts/family; extended and holistic approaches; appreciation of non-biomedical knowledge / practices and of manytypes, experiences and techniques of care; encouragement of self-healing, active participation and empowerment; family and community approach. In their organization of practices and relationship with customers there are affinities regarding: socio-cultural appropriateness; partnership, dialogue and democratization of relationships; territory-based work and stimulus to the establishment and use of therapeutic bondage. The convergences regarding their therapeutic and ethical-political effects are highlighted, and we discuss the relatively de-medicalizing character of these phenomena, more pronounced in psychosocial care and the search for integrative practice. Such affinities mean synergy between the three phenomena, up to now relatively independent and isolated from each other. The recognition and exploitation of these affinities by Collective Health theoreticians, by social movements and also health professionals and National Health System management can help to improve primary health and mental health care and to open it to the complementary and integrative practices, expanding the possibilities of care and strengthening the three phenomena.

Primary Health Care; Alternative and Complementary Medicine; Complementary and Integrative Practices; Psychosocial Care; Mental Health Reform; Public Health Policies

Faculdade de Saúde Pública, Universidade de São Paulo. Associação Paulista de Saúde Pública. Av. dr. Arnaldo, 715, Prédio da Biblioteca, 2º andar sala 2, 01246-904 São Paulo - SP - Brasil, Tel./Fax: +55 11 3061-7880 - São Paulo - SP - Brazil