Psychological Telecare in Traditional Communities of the Amazon during the COVID-19 Pandemic

Authors

DOI:

https://doi.org/10.5020/18061230.2026.15780

Keywords:

Telemental Health, Indigenous Peoples, Community Health Workers

Abstract

Objective: To describe and discuss the experience of implementing a telepsychological care strategy in traditional communities in the State of Amazonas during the COVID-19 pandemic. Method: Action research carried out within the project “SUS in the Forest,” conducted in traditional communities across 16 municipalities in the state of Amazonas, Brazil, between May 2020 and December 2022. The communities were selected based on their involvement in the COVID-Amazonas Alliance initiatives, considering territorial vulnerability, limited access to specialized mental health care, the presence of riverine and Indigenous populations, and coordination with Community Health Agents and Indigenous Health Agents. The study included an analysis of the pre-pandemic context, the organization of the strategy, and a descriptive analysis of care-related data. Results: In the pre-pandemic period, brown, Black, and Indigenous populations exhibited limited mental health care coverage and suicide rates higher than the national average. The psychological telecare experience was structured based on integrated strategies—tele-knowing, tele-planning, tele-acting, and tele-transforming—and relied on the central role of Community Health Agents (CHA), enabling the delivery of 469 psychological consultations between May 2020 and December 2022. A latent demand for psychological care was observed, as 95% of patients had no prior follow-up with psychologists. The main complaints included anxiety, depression, family-related distress, and social vulnerability. Conclusion: The experience described highlights the potential of psychological telecare as a strategy to promote mental health in Brazilian traditional communities, particularly in contexts of social and territorial vulnerability. It is emphasized that, although a universal and free public health system has been in place in Brazil since 1988, the “SUS in the Forest” will only become a reality through the adoption of digital and innovative strategies.

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Author Biographies

Andréia de Azevedo Swierczynski Pitombo, Open University of the Third Age Foundation, Manaus, Amazonas, Brazil

Holds a Bachelor's degree in Business Administration from the Higher Education University Center of Amazonas (CIESA) and in Psychology from the Nilton Lins University (UNL). Specialist in People Management (Dom Bosco Salesian Faculty - FSDB), Gerontology and Elderly Health (State University of Amazonas - UEA), Traffic Psychology (Única Faculty of Ipatinga - FUNIP), and Palliative Care and Pain Therapy (Pontifical Catholic University of Minas Gerais - PUC Minas). Holds a Master's degree in Gerontology from the Federal University of Santa Maria (UFSM). Currently a PhD candidate in Nanosciences at the Franciscan University (UFN), working as a researcher, professor, and Manager of Technological Projects and Social Actions at the Dean's Office for Education and Postgraduate Studies of the Open University Foundation for the Elderly (FUnATI).

Ivo Emílio da Cruz Jung , Open University of the Third Age Foundation, Manaus, Amazonas, Brazil

Bachelor's degree in Psychology from the Franciscan University Center (2011). Master's degree in Pharmacology from the Federal University of Santa Maria (2015). PhD in Pharmacology from the Federal University of Santa Maria (UFSM, 2021). Cognitive-Behavioral Psychologist at the Darlinda Ribeiro Polyclinic, Dean's Office for Health Care of the Elderly, Open Foundation for the Elderly. Researcher at FUnATI, State of Amazonas. Professor in the Postgraduate Specialization Program in Gerontology and Elderly Health at the State University of Amazonas (UEA). Coordinator of Worker's Mental Health at FunATI.

Verônica Farina Azzolin, Open University of the Third Age Foundation, Manaus, Amazonas, Brazil

Bachelor's degree in Biomedicine from the Cenecist Institute of Higher Education of Santo Ângelo (2013). Specialist in Public Health Management from UNINORTE (2023). Master's degree in Pharmacology from the Graduate Program in Pharmacology at the Federal University of Santa Maria-RS (2016). PhD in Pharmacology from the same program in (2018). Postdoctoral fellow through the FAPERGS/CAPES Researcher Retention Program in the area of Gerontology (2018–2020). Postdoctoral fellow through CNPq in the area of Gerontology and COVID-19 sequelae (2020–2022). Currently, she is Dean of Research at the Open University Foundation for the Elderly and collaborator professor in the Graduate Program in Gerontology at the Federal University of Santa Maria.

Euler Esteves Ribeiro , Open University of the Third Age Foundation, Manaus, Amazonas, Brazil

Rector of the University Foundation for the Elderly. Bachelor's degree in Medicine from the Federal University of Pará (1967) and PhD in Biomedical Gerontology from the Pontifical Catholic University of Rio Grande do Sul (2006). Currently, he is a Full Member of Chair No. 8 of the Amazonian Academy of Letters, guest professor at the University of Brasília, and guest professor at the Pontifical Catholic University of Rio Grande do Sul. Tenured professor at the State University of Amazonas, coordinator of the Postgraduate Program in Gerontology and Elderly Health at the Higher School of Health Sciences of the State University of Amazonas, and guest professor at the State University of Rio de Janeiro.

Virgílio Vianna, Sustainable Amazon Foundation, Manaus, Amazonas, Brazil

General Superintendent of the Sustainable Amazon Foundation (FAS). Bachelor's degree in Forestry Engineering, with a PhD in Evolutionary Biology from Harvard University and postdoctoral studies in Sustainable Development from the University of Florida. Currently, he is a member of the Pontifical Academy of Social Sciences at the Vatican, co-chair of the UN Sustainable Development Solutions Network for the Amazon (UN-SDSN Amazon), associate professor at the Dom Cabral Foundation, and member of the Council for Sustainable Economic and Social Development (CDESS), a body created by the President of the Republic.

Kelly Cristina Cebalho, Sustainable Amazon Foundation, Manaus, Amazonas, Brazil

Biologist (Bachelor of Science and Bachelor of Education), specialist in Environmental Education, Digital Education, and Educational Robotics. Undergraduate student in Pedagogy at UNIC.

Cristina Maranghello , Open University of the Third Age Foundation, Manaus, Amazonas, Brazil

Psychologist with a Bachelor's degree from the Pontifical Catholic University of Rio Grande do Sul (2015), specialist in Cognitive-Behavioral Therapy from the same institution (2024). Master's student in Aging Sciences at São Judas Tadeu University. Works as a psychologist and researcher, focusing on the mental health of vulnerable populations, especially the elderly and riverside communities in the state of Amazonas.

Ketlen Nascimento Gomes, Open University of the Third Age Foundation, Manaus, Amazonas, Brazil

Bachelor's degree in Psychology. Specialist in Psychomotricity, Gerontology and Elderly Health, and Music Therapy. Works at the Open University Foundation for the Elderly (FUnATI), where she conducts individual and group clinical care at the Gerontology Polyclinic and delivers workshops, lectures, and training in the field of Gerontology at the Education Coordination Office. Participates in the "Life and Health of the Active Elderly" project of the Executive Deputy Secretariat for the Rights of the Elderly (SEADPI), linked to the Secretariat of Justice, Human Rights, and Citizenship (SEJUSC) of the State of Amazonas.

Márcia Batista Santoro, Open University of the Third Age Foundation, Manaus, Amazonas, Brazil

Master's degree in Gerontology from the Federal University of Santa Maria - RS. PhD candidate in Humanities and Languages Education at the Franciscan University - UFN - Santa Maria - RS. Specialist in Gerontology from the State University of Amazonas - UEA. Specialist in Marketing from the Higher School of Advertising and Marketing - ESPM-RJ and FUCAPI-AM. Bachelor's degree in Social Communication with a concentration in Public Relations from the Federal University of Amazonas. Researcher and Education Coordinator at the Dean's Office for Education and Postgraduate Studies of the Open University Foundation for the Elderly - FUnATI.

Eduardo Vélez-Martin, Open University of the Third Age Foundation, Manaus, Amazonas, Brazil

Bachelor's degree in Biological Sciences, Master's degree, and PhD in Ecology from the Federal University of Rio Grande do Sul (1990, 1997, and 2012).

Ivana Beatrice Mânica da Cruz, Open University of the Third Age Foundation, Manaus, Amazonas, Brazil

Bachelor's degree in Biological Sciences from the Federal University of Santa Maria, Master's degree and PhD in Genetics and Molecular Biology from the Federal University of Rio Grande do Sul. Postdoctoral fellow at the University of California, Davis-USA. Currently Vice Rector of the Open University Foundation for the Elderly (FUnATI) of Amazonas, also coordinating the Center for Digital Personal Health associated with the Secretariat of Information and Digital Health of the Ministry of Health (SEIDIGI-MS), and Tenured Faculty Member of the Graduate Program in Applied Basic Immunology at the Federal University of Amazonas (UFAM) and the Graduate Program in Gerontology at UFSM. Holds a CNPq Scientific Productivity Fellowship (PQ1C), coordinating the research line in Nutri-Pharmacogenomics in Aging and Non-communicable and Communicable Diseases Associated with Aging, leading basic and innovation projects. Honorary member of the Amazonian Academy of Medicine.

Fernanda Barbisan, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil

Bachelor's degree in Biological Sciences from the University of the West of Santa Catarina (2010), Master's degree and PhD in Pharmacology from the Federal University of Santa Maria, and Postdoctoral studies in Gerontology (PNPD/CAPES-UFSM). Since 2021, she has been a Professor in the Department of Pathology at the Federal University of Santa Maria (UFSM). She is the coordinator of the Biogenomics Laboratory at UFSM. She serves as an undergraduate lecturer, teaching General Pathology for the Pharmacy and Nursing programs, and is a professor and advisor in the Graduate Programs in Gerontology (Master's) and Biological Sciences: Pharmacology (Master's and PhD) at UFSM. She is the substitute coordinator of the Graduate Program in Gerontology and deputy head of the Department of Pathology. She is a member of the Brazilian Society for Cell Biology and the Brazilian Society of Pharmacology.

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Published

2026-07-28

How to Cite

Pitombo, A. de A. S., Jung , I. E. da C., Farina Azzolin, V., Esteves Ribeiro , E., Vianna, V., Cebalho, K. C., … Barbisan, F. (2026). Psychological Telecare in Traditional Communities of the Amazon during the COVID-19 Pandemic. Brazilian Journal in Health Promotion, 39, 1–16. https://doi.org/10.5020/18061230.2026.15780

Issue

Vol. 39 (2026)

Section

Original Article

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Copyright (c) 2026 Andréia de Azevedo Swierczynski Pitombo, Ivo Emílio da Cruz Jung , Verônica Farina Azzolin, Euler Esteves Ribeiro , Virgílio Vianna, Kelly Cristina Cebalho, Cristina Maranghello , Ketlen Nascimento Gomes, Márcia Batista Santoro, Eduardo Vélez-Martin, Ivana Beatrice Mânica da Cruz, Fernanda Barbisan

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