Cidadania, politicas publicas e terapia ocupacional no contexto das ações de saude mental e saude da pessoa portadora de mdeficiencia no municipio de São Paulo

AUTOR(ES)
DATA DE PUBLICAÇÃO

1999

RESUMO

This work studies the process of construction and implementation of the political innovations introduced by São Paulo’s municipal government (89/92), within the context of the ‘Sistema Único de Saúde – SUS’ (the Brazilian National Health System), particularly those related to mental health and to the health of the disabled person. We further analyze the attention models proposed to each of these two areas and the role played in it by human resources; special care was given to the contributions made by the occupational therapists, who had been incorporated into the city’s health service staff by that government. We also investigate if the mentioned policies have been able to survive, during the next government (93/96), in order to measure to which extent the improvements reached before were (or were not), by then, consolidated. As an initial task, we defined a theoretical and historical framework, which set referential parameters to the general context in which the problems we here address were inserted: that of social policy, in a democratic capitalist state. We then discussed the relationships between social policies and the extension / reduction of the citizenship rights, in the international level – specially in what refers to the Welfare State experiences and to the neo-liberal way of State management – and the possibilities opened by that type of policies, concerning the areas under study, in Brazil (in the 90’s). From this point onwards, we used an empirical research that we have carried out: one of its main goals was to understand how each one of the participant actors of this process has viewed it. We focused our research in one out of the ten health regions which exist in São Paulo: the ‘Administração Regional da Saúde-6’ (ARS-6). 118 semi-structured interviews were done, with: central, regional and districtal managers, from the ‘Secretaria Municipal da Saúde’ and from ARS-6; technicians (social assistants, nurses, physiotherapists, speech therapists, doctors, psychologists and occupational therapists) and directors of services who developed health actions in the referred areas; service users and people representing the civil society health organizations and the health movements existing in the region. We drew then a plural and detailed panel of the building process of the social political innovations described, in the ARS-6, the strategies adopted for their accomplishment and the effects of those policies. The guiding themes that highlighted most actors’ interviews were categorized according to the methodology which followed from the theoretical references established, in such a way as to facilitate the study of the dynamic of the social policies changes. In this way, four great categories were defined and detailed, regarding the aspects selected in the interviews, as follows: evaluation of the previous situation; proposals; process and permanence. The main conclusions allow us to say that the 89/92 government managed to increase the degree of the accepted social needs in the health field, in general, and, in particular, in mental health and in the health of the disabled person, and that it was able to promote, with difficulties and within certain limits, advances towards the consolidation of health assistance proposals for those population groups. In this perspective, the actions of the social movements and also those of the health technicians’ movements were fundamental. The occupational therapist had important contributions to offer, along this process.

ASSUNTO(S)

saude mental terapia ocupacional politicas publicas cidadania deficientes

ACESSO AO ARTIGO

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