Illiteracy and Mental Health: The speech of users from a Brazilian Psychosocial Health Care Service

Abstract

Education is a relevant tool for empowerment and development of the potentialities of an individual. Moreover, the lack of education is associated with risk factors for mental health issues, such as low income, unemployment, and restriction of participation in the community (WHO, 2014). Education increases self-esteem, social relationships, encourages aspirations, and knowledge that can motivate attitudes and behaviors (Gomes, Miguel & Miasso, 2013). Our study aims to describe the experience of not literate users from a Psychosocial Care Center (CAPS type II), in Brazil, admitted from 2014 to 2017, concerning their socioeconomic and cultural context. Methods: After a sample selection according to the schooling degree, three users were invited to respond to a semi-structured interview, developed by the researches. Data were analyzed by its qualitative content analysis; thematic. Three categories were identified: (Dis) motivations of learning; The interrupted childhood, and; Labor market and adaptation to educational gaps. Results/ Discussion: In the first category, the participants reported not only the wish to return to school but they need to know new things through reading and writing skills. The feelings of being embarrassed and frustrated were identified in the failed attempts to perform the reading tasks, but curiosity under the meaning of language was predominant. The ability to read and write is more than a citizen right but reveals a way for social inclusion and to build a personal identity. It is an experience of citizenship and becomes a condition of social participation in its fullest (Haddad & Siqueira, 2016). Interruptions in school were related due to the lack of a family member or caregiver support to support their motivation at school. The second category presented childhoods with family responsibilities in early stages; where instead of attending schools and playing- essential characteristics of this childhood, they occupied their time doing domestic and working tasks to support their families. The third category comprised the consequences of non-literacy for the inclusion in the labor market and the impacts on the contractuality of these users in the face of a culture that uses language code as the main communication mean. The impossibility of literate understanding led them to adaptations, such as memorization, to facilitate the recognition of contexts. The improvement of these skills was one of the adaptation features that enabled the functionality of the individuals and supported ways of autonomy and income generation. Conclusion: We identified that the intersection of vulnerabilities, i.e., poverty, early work, mental illness, and fragilities in social and family support, turned into a barrier to accomplish their schooling and citizenship rights. Literacy is an elementary factor of recognition in a literate culture and its absence can be a label of exclusion and social stigma. There is a need for intersectoriality between services provided, at the theoretical, political and cultural domains, in order to fully delivery mental health care. It is equally important for health care practitioners to take into account historical and social issues, including user’s education, to enable justice, humanitarian and effective interventions.