In the resignation letter dated Tuesday, to which Lusa had access today, the eight psychiatrists affirm that the UMPP “suffers from various limitations and problems since its inception that have been systematically raised by the health professionals who work there and by their representatives”.
Addressing the letter to the president of the Board of Directors of the Regional Health Administration of the North (ARS-Norte), the regional coordinator of Mental Health of the ARS-Norte and the directors of the Psychiatry Services, the doctors point out that one of the “basic” problems of that urgency is the “absence of definition of referral criteria”.
The clinicians write that this problem was "already repeatedly reported and discussed in coordination meetings that deserved the preparation of a document by the UMPP coordination in 2018".
"At the beginning of 2020, in a meeting with ARS-Norte, the implementation of the referral criteria was communicated, but this never happened, contributing to the use of the UMPP of a huge number of cases without indication for observation in an emergency context and, thus, to an excessive and inappropriate influx of users”, they refer.
Emphasizing that since the beginning of the Covid-19 pandemic there has been a "sharp deterioration in the mode of operation" of the UMPP, affected by the "severe limitations in the transfer of patients to the emergency rear inpatient service (Hospital Magalhães Lemos)", doctors claim that the lack of articulation with this service “makes the current operating model unfeasible”.
In the letter, the eight health professionals say they have already, on several occasions, individually and collectively, denounced "the seriousness of these situations to different entities", but that in the "lack of answers and problem solving", they communicated their excuse of responsibility for risks arising from not solving problems that "put at risk the clinical safety, quality of service provided and dignity of users and professionals".
Referring to a meeting requested on July 9, with the Board of Directors of ARS-Norte, the doctors say that there are “difficulties in communicating” with that entity and that the meeting “has not yet been scheduled”.
"We also note the notorious lack of articulation between ARS-Norte and the UMPP Coordination, which culminated in Dr. Márcia Mota's recent request for resignation, with which we sympathize", the clinicians report, justifying the coordinator's resignation with the "lack of information" about the work plans at the Hospital Magalhães Lemos, the "lack of response" to the request for a meeting and not having been summoned to the ARS-Norte meeting, on October 1st, with the objective to discuss the current conditions of the UMPP.
“All these facts have caused deep indignation among the psychiatrists of the various institutions that participate in the UMPP and, naturally, among their team leaders, who have done everything to alleviate the effects of these serious problems in the care provided to users”, they add.
Lusa tried to obtain clarifications from ARS-Norte, but so far this has not been possible.
ARS-Norte told Jornal de Notícias, which announced today the resignation of the team responsible for the UMPP team, that ARS-Norte said it was "working" to try to solve the problem and assured that it has not given up on keeping Márcia Mota in her current functions, saying that "has been meeting and will continue to work with the coordinator in order to find a solution and see the possibility of staying in the position".
Since April 1, 2006, the UMPP has been operating at the University Hospital Center of São João (CHUSJ).