O fazer psicológico no Sistema Único de Saúde (SUS) em Manaus, Amazonas: formação, clínica ampliada e compromisso social com o território e com a saúde pública

Abstract

This study analyzes psychological practice within the Brazilian Unified Health System (SUS) in Manaus, Amazonas, seeking to understand how psychologists construct their work in a territory marked by social inequalities and cultural diversity. This qualitative research was conducted through semi-structured interviews with psychologists working in Primary Care, Psychosocial Care, and hospital settings, and the material was examined through Thematic Analysis. The results indicate that although Psychology education has undergone significant transformations, it still remains strongly grounded in an individualized clinical model and insufficiently integrated with public policies and the realities of local territories. However, everyday practices within the services reveal shifts in this paradigm, incorporating reception-based care, the Singular Therapeutic Project, collective actions, interdisciplinary teamwork, and territorial approaches as central dimensions of the Extended Clinic. The findings also highlight persistent challenges such as structural precariousness, work overload, fragile intersectoral articulation, and the continuous need for the legitimization of Psychology within hierarchical institutional contexts. Despite these barriers, the study identifies important potentialities that reaffirm Psychology in the SUS as a field of resistance, creativity, and ethical-political engagement, guided by the principles of Psychiatric Reform and public healthcare, the defense of autonomy, and practices sensitive to the singularities of each territory. It is concluded that psychological practice in the SUS in Manaus is a field in permanent construction, requiring reinvention and political and ethical commitment to public health.