Política de saúde mental no Brasil: o que está em jogo nas mudanças em curso

Dimensão epistêmica da Reforma Psiquiátrica Brasileira: significados de gestores, profissionais e usuários

“…Essa situação se mostra ainda mais preocupante diante do cenário vivenciado no Brasil de desmonte do SUS e de fragilização da Raps, especialmente a partir de 2017. Apesar dos avanços alcançados e da transformação substancial no sistema nacional de saúde mental, as iniciativas contrarreformistas se direcionam às abordagens institucionais e à subalternização sistemática das abordagens integradas de caráter comunitário 9 .…”

“…A trajetória da saúde mental no Brasil revela um processo de disputa de concepções epistemológicas e simbólicas sobre a loucura e o adoecimento mental. Mesmo que os progressos verificados no processo de desinstitucionalização sejam substanciais e revelem consistentes transformações nos últimos trinta anos, a política de saúde mental no pais está longe de ser considerada plenamente exitosa e se verificam diversas fragilidades na sua implementação 9 . Como agravante, as mudanças na política nacional de saúde mental e na política de drogas desencadeadas a partir de 2016, em especial com a inserção do hospital psiquiátrico à Rede de Atenção Psicossocial, com foco na abstinência, no fortalecimento das comunidades terapêuticas e nas internações psiquiátricas e no incentivo à biologização do cuidado, apontam para movimentos de ressignificação da dimensão epistêmica da RPB.…”

Global Mental Health and Pharmacology: The Case of Attention Deficit and Hyperactivity Disorders in Brazil

“…They are very few, and not restricted to service users, encompassing family members (mostly from lower classes) and professionals from public mental health services. Their role has been rather marginal when compared to the influence of those groups in other countries due to the lack of structure to organize their activities as well as insufficient funding and meager political support (Vasconcelos, 2013;Almeida, 2019). Several factors account for this precarious situation, including, the strong hegemony of patrimonial and hierarchical culture within Brazilian society resulting in a vertical organization with professionals on top of the hierarchy, enormous social inequality and the limited presence of public initiatives for mental health within the neoliberal public health policies (Vasconcelos, 2013).…”

“…Since the emergence of the psychiatric reform movement during the military dictatorship serious violations of human rights of imamates of psychiatric hospitals have been systematically denounced. The issue of guaranteeing human rights for people with mental disorders have expanded in the following decades for it was not a simple matter to humanize psychiatric hospitals, but rather to positively affirm the patients' right to fully exercise citizenship and to build communitybased, intersectoral care strategies that advance social inclusion (Delgado, 2011;Amarante and Nunes, 2018;Almeida, 2019). The issue of access and right to treatment is part of the human rights agenda, as well as the approval of legislation to regulate interventions and services, the encouragement of social participation, and the awareness of society to the challenges posed by mental illness.…”

“…The issue of access and right to treatment is part of the human rights agenda, as well as the approval of legislation to regulate interventions and services, the encouragement of social participation, and the awareness of society to the challenges posed by mental illness. There is a prolific debate around access to healthcare in the country and it is not limited to the evaluation of metrics related to diagnosis and treatment according to biomedical standards (Menezes et al, 2018;Almeida, 2019).…”