Cuidado em saúde mental nos Hospitais Gerais do Brasil: uma revisão das condições atuais sob a perspectiva da Rede de Atenção Psicossocial - RAPS

Objective: To investigate, through a literature review, the current conditions of care provided to patients with mental health disorders in general hospitals, including specialized wards and emergency services (emergency room), in light of the care perspectives established by the Psychosocial Care Network (RAPS). Methodology: This study consists of a bibliographic review of the integrative analysis type, with an exploratory nature and qualitative approach. Results and Discussion: The research analyzed the care provided to patients with mental disorders in general hospitals in Brazil, organizing the results into three thematic axes: stigma and prejudice in mental health, challenges faced by health teams, and the articulation of the Psychosocial Care Network (RAPS) in tertiary care. A total of 18 relevant studies were selected, highlighting how stigma and prejudice still negatively influence professional practices, perpetuating associations of dangerousness and loss of control with patients, and hindering the implementation of the psychosocial model advocated by the Psychiatric Reform. The lack of professional training, the still-present biomedical model, communication difficulties, and inadequate infrastructure were identified as major issues. The persistence of these problems contributes to care fragmentation, patient exclusion, and high readmission rates, describing the "revolving door" phenomenon. The results reinforce the need to overcome stigma, strengthen mental health training, and improve the articulation of RAPS in general hospitals, key elements for consolidating comprehensive, humanized, and territorial care aligned with the principles of the Brazilian Psychiatric Reform. Conclusion: The study investigated the current conditions of care offered to patients with mental disorders in general hospitals, based on the guidelines of the Psychosocial Care Network (RAPS). Using the integrative review method and analyzing three thematic axes, the data suggests that although general hospitals are part of the RAPS, the care provided often contradicts the principles of the Brazilian Psychiatric Reform, such as comprehensiveness and care in freedom. A significant limitation identified was the scarcity of scientific productions on the topic, which may have influenced the results. Few studies addressed successful practices in integrated mental health care within the hospital setting. However, the authors highlight the transformative potential of this model, provided challenges such as stigma, insufficient training of professionals, inadequate infrastructure, and ineffective communication between services are overcome.The findings reinforce the need for joint efforts between managers, healthcare professionals, and researchers to improve the substitute network, promoting more accessible, humane, and efficient care, aligned with the principles of the Psychiatric Reform.