Viabilidade de unidades psiquiátricas em hospitais gerais no Brasil

Abstract

OBJECTIVE:To comprehend the stigma against people with mental disorders still persists in the culture of general hospitals and acts as a limiting factor in the implementation of psychiatric units in general hospitals in Brazil. METHODOLOGICAL PROCEDURES:A qualitative social survey was outlined based on action research strategy as of the agreement to adopt a psychiatric unit in a general hospital in Taubaté, Southeastern Brazil. Data was obtained through interviews, participant observation and talks on the psychiatric unit project given to the hospital's clinical staff. RESULTS:The investment made by the healthcare authority enabled the stigmatizing conceptions (violence, moral weakness and untreatability) present in the hospital culture in question to be resignifi ed by means of clinical and sanitary discussions, which enabled the implementation of the psychiatric unit. The analysis showed that these concepts persist in this context because of a healthcare system that limits the access of people with mental disorders. CONCLUSIONS:The attitude of the healthcare authority, who decided to adequately fund the general hospital's psychiatric unit and exerted his infl uence over the hospital, was decisive for the outcome of the case. The main diffi culty in implementing psychiatric units at general hospitals is not the overcoming the existing stigma in the culture of general hospitals, but rather a diffi culty which is strategic in nature: the lack of an affi rmative policy for these units.

Hospitalizações psiquiátricas no Rio Grande do Sul de 2000 a 2011

“…One must also consider the possibility that psychiatric hospitalizations are not really sensitive to the articulation of local networks or that many links and compositions remain between services and professionals to allow post-hospitalization follow-up and effective integration between the different levels of care 10,27,28 . Anyway, the financing of the proposed model, not focused on hospital services, should not rely solely on the displacement of the hospital-level resources for the implementation of substitutive services 19,20 .…”

Hospitalization due to drug use did not change after a decade of the Psychiatric Reform

“…The interest in these data is due to the guideline policy that states funds invested in hospitalizations are reversed for the maintenance and expansion of substitute services on the psychiatric reform 13 . It is necessary to pay attention to the fact that the expansion of access of the population to mental health services can lead to the expansion of demand in all levels of care 17 , 22 . With this, it may be necessary to expand the structure and its technical capacity, also at the hospital level.…”

What is the emphasis of Brazilian drug policy: resocialization or internment?

“…Even the Ministry of Health having increased the value of the daily hospitalization in the general hospital, the scenario has not changed, which reinforces the ideological aspect that surrounds the issue. 19,20 The main reasoning of professionals and those interested in hospitalization in psychiatric hospitals, whether of people with psychic disorders or users of chemical substances, is that the costs of the care offered in the CPSA are higher than that of the bed in a psychiatric hospital and those of the general hospital and private clinics, which in Brazil are commonly called therapeutic communities. This term originates from a conceptual and operational error regarding the understanding of the attention model conceived by Maxweel Jones in England.…”