Emergências psiquiátricas, humanização e desafios contemporâneos no contexto da saúde: uma revisão integrativa da literatura

Abstract

Psychiatric emergencies are acute crisis situations requiring immediate, technically qualified responses from health services. According to the World Health Organization, approximately 970 million people — about one in eight — live with a mental disorder worldwide, and demand for psychiatric emergency care has grown substantially over the past decade, placing pressure on systems largely not designed to receive these individuals with dignity. This study analyzed the technical-scientific literature on psychiatric emergencies published between 2020 and 2025, focusing on contemporary challenges to humanized care and strategies documented in the literature. An integrative review with thematic narrative synthesis was conducted according to the PRISMA 2020 protocol. Searches were performed in PubMed/MEDLINE, BVS/LILACS and BDENF, and SciELO, between January and April 2026. A total of 287 records were identified; after removing 21 duplicates, 266 were screened by title and abstract. Of these, 184 were excluded at initial screening. The remaining 82 articles underwent full-text assessment; 20 were excluded with documented reasons, yielding a final corpus of 62 studies from 16 countries. Thematic synthesis was organized into seven axes: humanization in psychiatric emergencies; coercive practices and restraint; structural weaknesses and organizational barriers; COVID-19 pandemic impacts; therapeutic communication and person-centered care; public policies and Psychosocial Care Network (RAPS); and professional training, stigma, and specific vulnerabilities. Findings indicate that dehumanizing care in psychiatric emergency settings stems primarily from structural and organizational conditions consistently identified across different countries and health systems, rather than from individual professional failures. The COVID-19 pandemic exacerbated pre-existing vulnerabilities and deepened inequalities in access to care. Verbal de-escalation programs, mental health-specific triage, and organizational cultures oriented toward alternatives to restraint significantly reduce coercive episodes without increasing adverse events.