Abstract
RESUMO O objetivo do artigo foi analisar a estrutura e o processo de cuidado nos Serviços Residenciais Terapêuticos existentes no município do Rio de Janeiro. Trata-se de um estudo transversal que se concentrou na coleta de informações primárias por meio de instrumento estruturado. A pesquisa foi realizada em todos os dispositivos em funcionamento no mês de dezembro de 2016. No Rio de Janeiro, as Residências Terapêuticas recebem essencialmente pacientes egressos de internações psiquiátricas de longa permanência (94,3%), com grande oferta de vagas em dispositivos com presença de equipe nas 24 horas do dia (63,8%). Foi constatado que parte significativa dos moradores apresentava baixa frequência nas atividades assistenciais dos Centros de Atenção Psicossocial (48,7%). O cuidado interno nos dispositivos residenciais aponta para uma modelagem com forte entrelaçamento entre a moradia e as ações de reabilitação psicossocial. A baixa rotatividade de usuários mostra uma tendência para constituição de serviços com cuidado de longo prazo, o que deve ser levado em conta na manutenção e na expansão do programa no intuito de planejar serviços efetivos. Os resultados apontam que as bolsas de apoio à desinstitucionalização e, principalmente, a renda contínua aferida mediante o Benefício de Prestação Continuada são vitais para a sustentabilidade do programa.
Highlights
Since the 1950s, several countries have implemented mental health policies based on the common central element of shifting the axis of care from hospital to the community, characterizing the process called deinstitutionalization of psychiatric care[1]
This paper aims to analyze the functioning of Therapeutic Residential Services (TRS) in mental health in the city of Rio de Janeiro in 2016, with an emphasis on its structure and the care process
Shorter[2] affirms that the primary issue in the post-WW2 years is the gradual inclusion of mental health in the scope of social insurance and the welfare state. He considers that the 1970s witnessed the important inflection concerning deinstitutionalization, with lower availability of beds in all European countries, marked by the integration of psychiatric care with health systems
Summary
Since the 1950s, several countries have implemented mental health policies based on the common central element of shifting the axis of care from hospital to the community, characterizing the process called deinstitutionalization of psychiatric care[1]. Shorter[2] affirms that the primary issue in the post-WW2 years is the gradual inclusion of mental health in the scope of social insurance and the welfare state. He considers that the 1970s witnessed the important inflection concerning deinstitutionalization, with lower availability of beds in all European countries, marked by the integration of psychiatric care with health systems. The deinstitutionalization process was not uniform in all European countries, with different levels of service implementation, but most countries, especially in Western Europe, have a comprehensive network of quality community services in mental health[3]
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