Governamentalizando a liberdade e o gênero: pequenas notas genealógicas sobre a reforma psiquiátrica brasileira no seu cotidiano

Based on an integral healthcare model for the users of alcohol and other drugs, the expansion of Brazil's Psycho-Social Care Centers - Alcohol and Drugs (CAPS-AD) is guided by the acknowledgement of users as citizens rather than patients, aiming at social reinsertion through an intersectoral approach and damage control, as well as other principles designed to build up integral healthcare services that are fair and egalitarian. This paper examines alcohol and drug users, their companions and healthcare practitioners in terms of the existing healthcare model, through a study conducted at two Psycho-Social Care Centers - Alcohol and Drugs in Recife, Pernambuco State. Focus groups, participative observation and documentary surveys were used to analyze the daily work routines at these Centers, exploring player perceptions and therapeutic projects. The findings indicate that users are still perceived as being ill, with medicalization and other traces of care models not used since the Psychiatric Reform. Social reinsertion was perceived as the main obstacle in integral healthcare. Restructuring this practice seems necessary, in order to break away from a culture of prejudice, exclusion and illness, as well as control models based on hospital-centric psychiatry.

Deinstitutionalization enables the removal of users from asylums with the support of the Psychosocial Care Network (PCN), which is based on the Psychosocial Care Centers (PCCs). One of the current impasses is the emergence of private/religious institutions that are updating the asylum model. In order to analyze what leads to neo-institutionalization in these locations, an ethnographical study was carried out on nine cases in four PCCs of the three PCNs in the city of Rio de Janeiro, through scrutiny of medical records, interviews with the patient, family members, PCC technicians and managers of the asylums per se. These locations were institutionalized despite the support of the PCCs and were selected for the research due to the diversity of characteristics, territories and institutional destinations that permitted investigation. The conclusion drawn is that neo-institutionalization is motivated by different factors: crisis, asylum concept, disarticulation and precariousness of intra- and intersectoral networks, reduced teams and insufficient number of territorial services, institutionalization of PCCs, low crisis reception capacity, family overload and family expectations, lack of regular support for family members and housing projects for users whose caregivers have died, are elderly or become ill.

To analyze how the nursing team from a Psychosocial Care Center II relates its insertion in the service with the work process. Descriptive, analytical research outlined as a case study with a qualitative approach. The data were collected through semi-structured interviews with nursing professionals and went through content analysis subsidized by Bardin's work. Two thematic categories emerged: a) Ways of intake in the nursing services at the Psychosocial Care Center; b) Setbacks in nursing routine at the Psychosocial Care Center. The fact that the professionals have not planned to work in mental health nor have training impacts the rhythm of psychosocial care development at the Psychosocial Care Center, forcing them to seek training in the field after admission. Unmotivated by the working conditions, the nursing team suffers from the absence of an interdisciplinary partnership and goes to great lengths to approach psychosocial care.

Objectives: Identify psychiatric nursing practices in the mediation of autonomy for social individuals compromised by their psychiatric history, and analyze psychiatric nursing practices focused on the autonomy of individuals who attend a type III psychosocial care center. Methods: Convergent-care research using observation and semi-structured interviews with seven RN nurses from a psychosocial care center and four educational groups in the year 2013. Data analysis used social constructivism as its foundation. Results: Autonomy is presented as a care action that enables users to be the protagonists of their own lives, recognizing their limits and possibilities. Even with mental conditions, patients' potentialities must be recognized. Conclusion: Nurses invest in autonomy and liberty as foundations of care to be stimulated, mediated, or negotiated. Implications for practice: The inclusion of "autonomy mediating" as a care action for patients is emphasized.

Introduction:Workplace violence against health care professionals is a highly prevalent problem and is considered a public health concern by the World Health Organization. Yet most studies on the topic focus on its negative impact on the mental health of workers rather than the causes of these incidents.Objectives:To describe the frequency of workplace violence and its impact on professionals working in Psychosocial Care Centers (Centros de Atenção Psicossocial [CAPS]) in a large city in the state of São Paulo.Methods:A quantitative cross-sectional study was conducted on a non-probabilistic sample of 193 health care workers across 11 Psychosocial Care Centers. Participants completed two self-administered instruments: a biosocial questionnaire and the Survey Questionnaire on Workplace Violence.Results:The results showed that 42.4% of respondents had suffered physical violence; 64.8% had experienced psychological violence; and 29.5% had been victims of bullying/mobbing. In most cases, the victims responded to these incidents by taking no action, asking the perpetrator to stop, or speaking of the incident to a colleague or superior. A verbal warning was issued to perpetrators in only 21% of cases of physical violence. Mobbing had the greatest negative impact on respondents, followed by psychological and physical violence.Conclusions:Workplace violence is a part of everyday work in Psychosocial Care Centers. Though this violence is often naturalized and considered a collective defense against suffering, it did not prevent participants from reporting high levels of job satisfaction, reflecting the degree to which professionals at Psychosocial Care Centers are committed to their colleagues and to service users, as well as their search for professional recognition.

The present study has as objective to identify the burden, experienced by the family member in charge of taking care of his relative, who is a user of a small town 'Psychosocial Care Center', located in the state of Sao Paulo, Brazil. A semi- structured questionnaire was used, in order to obtain a characterization of the family members, based on both, their life story and other topics related to the patient's psychological illness. The interviews were carried out with 9 family members, from 28 to 80 years old, being most of them the patients' mothers. The data were analyzed by using a qualitative analysis, thus forming theme categories that indicated the presence of an emotional, practical and financial overload to the family member in charge of the patient's daily care. The study emphasizes the need for a support group, mainly during crisis. It also points out the advanced age of the caretakers, as an aspect to be considered by the teams that work in the mental health field, in the view of the Brazilian public policy, which open the possibility of looking after the patient with mental disorders within his social and familiar context.

Since physical activity (PA) is capable of improving both the quality of life and the prognosis for individuals with mental and behavioral disorders (MBD), the main purpose of this study was to analyze the PA patterns in individuals with MBD frequenting a Psychosocial Care Center (PCC) in the city of Pelotas. The target population of this descriptive study consisted of individuals attended in any of the PCCs of Pelotas. The sample was selected from six PCCs and comprised 85 patients and their relatives. The mean age of the sample was 40.9 years (standard deviation 13.8). It was found that, in comparison with the general population, these individuals had a lower socioeconomic level and less schooling. The prevalence of leisure-time physical activity was low. In addition, women tended to dedicate the greater part of their time to household activities. Men participated more in the PA offered by the PCC than women. Therefore, incorporation of PA in PCC seems to be a feasible initiative for supporting the treatment of these patients and would offer a unique opportunity for the patients to engage in supervised and structured PA programs.

to describe and analyze a strategy of continuing health education to manage the quality of professionals' work in Psychosocial Care Centers. this is a research-intervention carried out in Psychosocial Care Centers in the state of Goiás, Brazil, with the participation of 58 professionals. Data were collected in 2016 through seminars and workshops. Thematic content analysis was carried out. professionals associated the Singular Therapeutic Project to the record of performed procedures and described the need to develop skills for correct completion and interpretation of procedures, use of a record software and computerization of processes. The qualification strategy used was considered to be effective in making improvements to the work carried out feasible. the study presents a qualification strategy for community mental health service teams to guide the care model for territorial care centered on users.

Introduction: the suppression of the asylum care model in mental health in Brazil under the influences and in light of the psychiatric reform, ends a new epistemological paradigm with a focus on the individual as a subject in the care processes, breaking with the asylum logic surrounding the disease and promoting their participation and protagonism in biopsychosocial spheres. The general objective of the study is to: Describe the practices and performance of Occupational Therapy professionals in Psychosocial Care Centers (CAPS). This is an integrative literature review of a descriptive nature. The search for articles was carried out in the databases Latin American Literature in Health Sciences ( Lilacs ), Scientific Library Online (SciELO), Portal de Periódicos Cadernos Brasileiros de Terapia Ocupacional / Brazilian Journal of occupational Therapy (UFSCar), Revista de Terapia Ocupacional da Universidade de São Paulo and Revista Interinstitucional Brasileira de Terapia Ocupacional (REVISBRATO) using the descriptors: ‘’Mental health’’, ‘’Occupational Therapy’’, ‘’Psychosocial Care’’ and ‘ ‘Deinstitutionalization’’. With the Boolean operator AND for the specifics of the survey. Articles that were available in full, consistent with the objectives of the study, were included. 472 articles were found, of which 10 were selected. From this, it was found that the practices of Occupational Therapy professionals are based on interventions that consider the precepts of intersectorality, interdisciplinarity, singularity and integrality as effective care practices with regard to psychosocial care. The occupational therapist’s work considers daily life, exchanges and experiences in the territory as the preponderant locus of intervention, understanding that individuals are a product of social reality and at the same time are subjects in the process of building and transforming the world and themselves historically. . The care process presents great challenges and must move away from pre-established and/or standardized models, since users are a reflection of the social environment in a complex, subjective dynamic, endowed with contradictions and singularities.

Objective: to know and analyze the trend of Brazilian scientific production on the Singular Therapeutic Project in Psychosocial Care Centers. Methodology: this is a narrative review of the literature, carried out on the theses and dissertations portal of the Coordination for the Improvement of Higher Education Personnel, in June 2022. Results: the Singular Therapeutic Project provides the user and their family with the protagonism in care, making them co-responsible for it. The instrument is based on the use of light technologies, such as listening and welcoming, which corroborates the emancipatory care in mental health. It enables the services of the psychosocial care network to move towards the management of mental health care based on the humanized, integral and equitable health model. Furthermore, the Singular Therapeutic Project appears as an important way to build public policies based on the real needs of the territories and assisted users. However, it is known that there are still important challenges facing the construction of the instrument, which directly impact the democratic management of the instrument. Final considerations: the study made it possible to know the scientific productions of graduate programs about the Singular Therapeutic Project in Psychosocial Care Centers, which predominantly use qualitative research methods. Furthermore, it made it possible to identify the weaknesses that still exist in the services of the care network, providing a basis for the development of future research and actions in the field of mental health.

Qualified Listening to Relatives of Users at a Psychosocial Care Center

A pesquisa investiga a reforma psiquiátrica no Brasil e os desafios para sua concretização, de modo que, inicialmente, se dedica à compreensão do sofrimento mental buscando o relato histórico das terapias para o enfrentamento da questão. Posteriormente, identifica-se o desenvolvimento da legislação nacional para a proteção da pessoa com sofrimento mental e, por fim, a pesquisa investiga os desafios da reforma psiquiátrica caracterizados pela extinção gradativa dos asilos e hospitais psiquiátricos, pelo oferecimento de atenção e cuidado junto da família e da sociedade, por meio do atendimento oferecido pelos Centros de Atenção Psicossocial.

Discusses the family insert in mental care health in a Center for Psychosocial Care (CPC). This subject emerged from a wider research of Evaluation of Centers for Psychosocial Care in the south area of Brazil, denominated CAPSUL, and the results here presented have been originated from the qualitative stage of the study. It is an evaluating research, of the type case study, accomplished in a Center for Psychosocial Care of Joinville the municipality of the State of Santa Catarina, in the period July-August 2006, that grew starting from the Evaluation of Fourth Generation, constructionist, responsive and a hermeneutic-dialectics approach. The instruments of data collection were the interviews with team, users, family and field observation. Starting from the systematic grouping of the nuclei of meanings, it was possible to reach two discussion axes. In the first of them, entitled the family while caretaker unit, we gathered the users' positioning and of the relatives due to they believe in family as dimension of the treatment. In the second, entitled CAPS as support dimension to the family, we worked with the data produced by the interviews which discussed the role of the service in providing support and integrating that family in the therapeutic project.

redes substitutivas e territoriais que visem à superação do modelo hospitalocêntrico, à conquista de cidadania e à criação de um novo lugar social para a experiência do sofrimento psíquico.Para garantir a materialidade dessas mudanças, faz-se necessária a participação efetiva dos usuários na

In recent decades, public policies of the Unified Health System (SUS) in Brazil have structured a community mental health care network (RAPS) based on various community actions and services. This study carried out evaluative research on the implementation of the structure and process dimensions of this care network in Minas Gerais, the second most populous state of Brazil, generating indicators that can enhance the strategic management of the public health system in the strengthening the psychosocial care in the state. The application of a multidimensional instrument, previously validated (IMAI-RAPS), in 795 of the 853 municipalities in Minas Gerais was carried out between June and August 2020. Regarding the structural dimension, we noticed an adequate implementation of services like ‘Family Health Strategy,’ ‘Expanded Family Health Center,’ and ‘Psychosocial Care Centers’ but a lack of ‘Beds in General Hospitals’ destinated to mental health care, ‘Unified Electronic Medical Records’ and ‘Mental Health Training Activities for Professionals.’ In the process dimension, adequate implementation of actions such as ‘Multidisciplinary and Joint Care,’ ‘Assistance to Common Mental Disorders by Primary Health Care,’ ‘Management of Psychiatric Crises in Psychosocial Care Centers,’ ‘Offer of Health Promotion Actions,’ and ‘Discussion of Cases by Mental Health Teams’ point to a form of work consistent with the guidelines. However, we detected difficulties in the implementation of ‘Psychosocial Rehabilitation Actions,’ ‘Productive Inclusion,’ ‘User Protagonism,’ ‘Network Integration,’ and practical activities for the effectiveness of collaborative care. We found a better implementation of the mental health care network in more populous, demographically dense, and socioeconomically developed cities, which shows the importance of regional sharing of services that are not possible for small cities. The evaluation practices of mental health care networks are scarce throughout the Brazilian territory, a fact also found in Minas Gerais, highlighting the need for its expansion not only in the scientific sphere but also in the daily life of the various levels of management.