Entre o hospício e a cidade: exclusão/inclusão social no campo da saúde mental

Abstract

The aim of the present work is to contribute to the understanding of problems related to the notion of social exclusion in the mental health field, based on the study of the living places for people egressed from psychiatric hospitals. Data were collected from recorded conversations and registered in field diary during the research in three cities in the state of São Paulo.The notion of social exclusion is approached as it is frequently mentioned in political discourses and proposals. Spatial segregation and urban exclusion are focused, considering the 'meanings of living' as the central aspect. In everyday practices in Mental Health exclusion is associated to being banned from the social life and it is amplified to social problems in the spheres which define policies but they bring no important difference for policies formulation beyond the usual meanings of the question.The meanings of living, expressed in different populational groups and singularly by each person, guided the discussion to the question of policies and practices. Such practices, when the diversity of experiences is not taken into account, tend to reproduce the manicomial reasoning that they are supposed to overcome, even if they are based on the so called inclusive proposals.The transit among people egressed from the psychiatric hospitals and people living in the city, among knowledge areas and diversity of practices is presented as a possibility of interrupting the vicious circle which rearticulates the traditional practices and discourse in psychiatry. The understanding of 'ways of living' allows us to recover part of the story of habits which were lost in the urbanization process and instigates us to consider emergent questions in the field of mental health in the context of problems of the cities in the contemporary world.

Psicologia, política pública para a população quilombola e racismo

“…Within this same context, which demands that the subject be treated as a citizen, we postulate that state intervention must consider different levels of action: from concrete actions to those geared towards social representations and unconscious representations; from actions related to the intersubjective to those concerning the intrapsychic; from the legal-political sphere to social-cultural spheres, among others (Scarcelli, 2011).…”

A critical view of the ‘social reinsertion’ concept and its implications for the practice of psychologists in the area of mental health in the Brazilian Unified Health System (Sistema Único de Saúde)

“…The literature points out the risks, for practice, of the shortcomings that characterize the concept of 'social reinsertion' in the process of exclusion/ inclusion. According to Scarcelli (2011), one must ask whether the practices that might combat social exclusion -such as the inclusion or social reinsertion -are not simply constituted as '[…] ways to mitigate the effects of what is meant by exclusion' (p. 49). Or if it is not a perverse inclusion, which only reproduces inequality, instead of transforming the relationships between human beings, as reflected by Sawaia (2014).…”

Entre a saúde coletiva e a saúde mental: um instrumental metodológico para avaliação da rede de Centros de Atenção Psicossocial (CAPS) do Sistema Único de Saúde

“…Considerando que, no Brasil, setores progressistas da reforma psiquiátrica ocupam lugar de destaque na formulação e na condução executiva das mudanças em saúde mental, acreditamos ser oportuno incluir no processo de avaliação dos dispositivos criados para a implementação da reforma, atores que, de alguma forma, mantém-se à margem do processo, em posturas essencialmente críticas, o que pode reduzir eventuais pontos cegos dos gestores e formuladores de políticas 67 .…”