O dispositivo “técnicos de referência” nos equipamentos substitutivos em saúde mental e o uso da psicanálise winnicottiana

Abstract

A despeito da ampla utilização do dispositivo “técnicos de referência” como forma de organizar a atenção nos Caps e outros equipamentos da reforma psiquiátrica, permanecem ainda restritos os debates e análises de suas limitações e potencialidades. Discutiremos aqui caminhos para que a organização de serviços com base em técnicos de referência não seja capturada pela administração burocrática, perdendo sua potência transformadora. Baseando-nos na clínica proposta por Winnicott, discutiremos também os problemas decorrentes da noção de “vínculo” – inerente ao dispositivo em questão – quando transposto para os serviços substitutivos de saúde mental.

Access, equity and social cohesion: evaluation of intersectoral strategies for people experiencing homelessness

“…The interdisciplinary work and the bonding were found (27) , as well as the investment of workers in the inclusion of a social group that suffers with the stigma of madness (28) . Thus, the technicians provide the construction of spaces of sociability different from those where their clientele live, to make bearable an everyday life that, above all, is afflictive (19) .…”

Análise do trabalho de referência em Centros de Atenção Psicossocial

“…In spite of this, in the fi eld of relationships between workers and users, therapeutic processes take place, as acknowledged by the latter. However, there are few academic studies on the reference work clinic, in the particular context of mental health, 8 thus limiting professionals to a more theoretical basis and also the possibilities of associating this work with the clinic.…”

“…The key feature is the fact that the professional, by means of a shared plan, becomes responsible for following the patient, considering social, familial, political, and psychological aspects. 8,9 The reference teams/professionals arrangement seeks to maximize the effects of shared management of interdisciplinary services, overcoming hierarchical, fragmented and authoritarian organization models. 4 In other countries, mental health policies adopt a type of work which is closer to reference Brazilian professional teams, called case management.…”

“…Few publications on the reference work clinic aimed at psychotic patients, their functions and specifi cities can be found. 8 Given the offi cial recommendation for its use, this study aimed to analyze how workers, users and family members assess reference teams from psychosocial care centers. The purpose is to understand if this arrangement has therapeutic effects, what theoretical conceptions its practice has been based on, and what its result is in the work organization and workers' psychic life.…”

Análise das equipes de referência em saúde mental: uma perspectiva de gestão da clínica

“…A despeito da ampla utilização desse arranjo, bem como de sua importância para a viabilização do tratamento, ainda são escassos os trabalhos que avaliam sua implantação e funcionamento, bem como balizamentos éticos e conceituais que o sustentam 6,8 .…”