Desinstitucionalização Psiquiátrica no Brasil: riscos de desresponsabilização do Estado?

Abstract

O artigo analisa o processo de desinstitucionalização resultante do movimento de Reforma Psiquiátrica, discutindo, em especial, o lugar destinado pelas famílias das pessoas com transtornos mentais (PCTM), a partir das alterações nas funções do Estado neste processo. Baseia-se em revisão bibliográfica. No que concerne à trajetória histórica da família brasileira e, mais especificamente, da família no contexto da saúde mental, que deslocam os papéis e lugares dos diferentes grupos familiares na direção do processo de inserção comunitária das PCTM, constatou-se que não basta fechar os manicômios ou reduzir o número de leitos psiquiátricos, se antes não forem modificados os significados desses aparatos nos cernes familiar, comunitário e social. Para que a Reforma Psiquiátrica se efetive, a família tem que ser vista como agente fundamental de transformações da percepção de loucura, bem como ser incluída de forma responsável no processo de cuidado, recebendo suporte e partilhando atribuições juntamente com o Estado e a comunidade.

Enfermagem e o processo de desinstitucionalização no âmbito da saúde mental: revisão integrativa Nursing and the deinstitutionalization process in the mental health scope: integrative review

“…In this context, it was adopted and qualified network of intermediary services in mental health, for the community, based on interdisciplinary and multidisciplinary work in health, where nursing professionals enrolled in the social, historical and political dimension, and the condition a member of this team has an important role in the user's treatment. [1][2][3][4][5][6][7][8][9]19 As the historical process of the psychiatric reform strengthened in many countries associated with the adoption of therapeutic instruments with emphasis on care in psychosocial rehabilitation and psychotherapy groups, it directly influenced the current international scenario of care for mental health nursing. [18][19][20] A recent study in Brazil investigated the perceptions of nursing professionals about the Psychiatric Reform and its relationships to the technical and scientific training and professional practice.…”

“…14,20 Mental health in the context of psychosocial care and its interface with the Family Health Strategy (ESF) suffer from a shortage of skilled human resources. 1,7 Nursing care processes to the person with mental disorders in psychosocial care brought by the reform expose the challenge to be overcome, the predominance of bureaucratic and administrative activities by the nurse in a mental health service. [18][19][20] To do this, they propose changes in the educational system in the formation of nursing professionals for a new mental health care.…”

“…Strengthens the idea of the movement of Psychiatric Reform, which requires health professionals a focused humanized practice for psychosocial rehabilitation. [1][2][3] In Brazil, supported by Law No. 10.216/2001, the Brazilian Psychiatric Reform begins in the late 1970s with the workers in Mental Health Movement, known as antiasylum struggle movement and under the influence of the Italian transformation model, pointed deinstitutionalization as a fundamental premise in the reorganization of services and the mental health practices.…”

“…10.216/2001, the Brazilian Psychiatric Reform begins in the late 1970s with the workers in Mental Health Movement, known as antiasylum struggle movement and under the influence of the Italian transformation model, pointed deinstitutionalization as a fundamental premise in the reorganization of services and the mental health practices. [1][2] It redefines the focus of the psychiatric clinic for the process to take care of a multidisciplinary nature. Therefore, the movement proposed overcoming the psychiatric paradigm not alluding to the dismantling of hospitals, but all the power relations surrounding the disease object, which may be even in the territorial services.…”

“…This new order was intended to (re) integration, user building citizenship and autonomy and demystification about madness, stigmatized throughout the centuries. 1,7 The National Mental Health Policy in force in Brazil, aims to progressively reduce beds in psychiatric hospitals, expanding, qualifying and strengthening the extra-hospital network through the implementation of alternative services as: Psychosocial Care Centers (CAPS), Residential Services Therapeutic (SRT) and Psychiatric Units in General Hospitals (GHPU) -including the actions of mental health in primary care, implementation of comprehensive care policy to users of alcohol and other drugs, Back Program for Home, among others. 7 In this conjuncture and historical perspective, the nursing care to people with mental disorders in Brazil aligns the reformist principles requiring health professionals a practice contrary to the started with traditional psychiatry.…”