Utopia da realidade : contribuições da desinstitucionalização para a invenção de serviços de saude mental

AUTOR(ES)
DATA DE PUBLICAÇÃO

2003

RESUMO

In the last two decades psychiatric care in Brazil has gone through a process of criticisms and proposals of change known as psychiatric reform. By the end of 1980s, under the emblem ?For a society without mental asylums?, devised by the Mental Health Workers? Movement, there was a fracture of existing conceptual milestones and political and functioning strategies, giving rise to a new scope of possibilities and ethical, theoretical, social, institutional and legal challenges.In 1990s, the assertion of citizenship rights of individuals with mental health disorders and removal of the asylum model were the main guidelines in the reform process for implementing a national mental health policy that will encompass major changes in care, legislation and social and cultural spheres. Despite the dissemination of reform proposals and a wide range of initiatives, there is today in the national scenario a centralized asylum model and an organized movement for new services and experiences. Thus, the creation of local projects and replacement services, especially psychosocial care services, is one of the major challenges of psychiatric reform in the context of the Unified Health System in Brazil. The present study has the purpose of investigating the process of building up the Northwestern Psychosocial Care Unit (NAPS) given the mental health experience gained in the municipality of Santos for the period between 1989 and 1996, based on documentation, bibliography, prior studies, and field reports. On the grounds of theoretical referential of deinstitutionalization and exchange of ideas on proposals of changing the way of thinking and acting in collective health, it seeks to build on and reflect on major subjects for the creation of NAPS?s routine as an open, 24-hour, community-based replacement service, and questioning the process? breakthroughs and contradictions. Moreover, it introduces and discusses the critical knowledge built on practices of reality changes from Gorizia and Trieste?s experiences, expressing and proposing a different ethical, theoretical, and political viewpoint to understanding madness and its relationships in the social context. It allows therefore for a new way of thinking the creation of replacement services and inserting it into the complex process of deconstructing knowledge, institutions, values, and cultural issues.Regarding psychosocial care services as institutions of deinstitutionalization, it is reasoned that services become replacements in the creation of a new reality allowing for the creation of new exchange of ideas with the complexity of existence-suffering, ways of exercising one?s own rights and a new social setting for madness experience

ASSUNTO(S)

desinstitucionalização saude mental serviços de saude mental comunitaria

ACESSO AO ARTIGO

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