title: Convergence and Non-Convergence: stories of elderly who have attempted suicide and the Integrated Care System in Porto Alegre/RS, Brazil.
abstract: This article is the product of research undertaken in the city of Porto Alegre, in the Brazilian state of Rio Grande do Sul. The goal is to bring to light and discuss a little known phenomenon - attempted suicide by the elderly. Under-reporting of suicide attempts among this population makes it difficult to place this serious public health problem on the political agenda. As part of this study, we interviewed not only elderly persons who had attempted suicide, but also their family members and mental health and emergency and urgent service professionals. These interviews took place during the course of 2014. From a textual discourse analysis of the various reports, there emerged a category we will call Convergence and Non-Convergence, which deals with the relationship between the elderly population's need for care and the healthcare model in use. This study uses three short stories of individuals to question the biomedical model of serving risk situations, stressing the concept of an Expanded Clinic to provide integrated healthcare. This concept focuses on the different types of care and the uniqueness of each user, which often the biomedical model neglects. This study also highlights the need to develop a line of care for the elderly, with investments in continued education about active aging and care in times of crises, articulating a cross-sectorial network.
authors.affiliation: Secretaria de Estado da Saúde do Rio Grande do Sul, Brasil.
authors.forename: Marta
authors.initials: M
authors.lastname: Conte
authors.affiliation: Secretaria de Estado da Saúde do Rio Grande do Sul, Brasil.
authors.forename: Claudia Weyne
authors.initials: CW
authors.lastname: Cruz
authors.affiliation: Secretaria de Estado da Saúde do Rio Grande do Sul, Brasil.
authors.forename: Carla Guimarães
authors.initials: CG
authors.lastname: da Silva
authors.affiliation: Secretaria de Estado da Saúde do Rio Grande do Sul, Brasil.
authors.forename: Nara Regina Moura
authors.initials: NR
authors.lastname: de Castilhos
authors.affiliation: Secretaria de Estado da Saúde do Rio Grande do Sul, Brasil.
authors.forename: Alberto Domiziano Rita
authors.initials: AD
authors.lastname: Nicolella
mesh_terms: D000368:Aged; D001938:Brazil; D003695:Delivery of Health Care; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013406:Suicide, Attempted / Q000523:psychology