Paper short abstract:

This presentation analyzes the strategies that primary care health professionals deploy to respond to demands coming from health services institutions and health systems users to provide medical solutions to emotional distress in Uruguay, a middle-income country universal health coverage.

Paper long abstract:

This paper analyzes strategies that primary care health professionals deploy to respond to demands of health services institutions and users to provide solutions to emotional distress in Uruguay, a middle-income country that has recently undergone a health system reform.

The presentation draws on findings from two projects, one conducted in 2013-2015 which explored health professionals perceptions on the role of benzodiazepines in their clinical practice, and another one conducted in 2015-2017 on benzodiazepines' users practices on psychopharmaceuticals consumption. In the first project we interviewed general practitioners, family doctors, psychiatrists and psychologist while in the second we interviewed benzodiazepines users.

Health professionals narratives show that they see themselves facing an increasing demand from health users to solve emotional problems that they consider rooted in social and economical factors and for which psychopharmaceuticals is the only means they have to respond. They also show how institutional demands and regulations of health services force them to resolve mental health consultations on the primary care level starting and following up psychopharmaceutical treatments until referral to specialist is possible. Paradoxically, benzodiazepines users narratives show that even though they ask health professionals to provide rapid solutions to emotional problems, they regulate themselves medication treatments deciding when and how to take psychoparmaceuticals and how to access to them without health professionals participation.

We discuss that the role of health professionals is challenged both by institution and users and that in order to face this situation they trace a dividing line between legitimate and non legitimate psycopharmaceutical consumption practices.