Reinternação psiquiátrica no campo da atenção psicossocial: a perspectiva dos pacientes reinternantes

Abstract

Conceptions about madness, as well as how to treat it, have been undergoing considerable changes according to culture and period. From the 1990s, the Psychiatric Reform was official in Brazil, starting the policy of deinstitutionalization and social reintegration. However, a few challenges are still observed, including the readmissions in the sector of brief hospitalization in a psychiatric hospital, which has serious consequences, such as the propensity to a new form of institutionalization. This study aimed to: analyze the phenomenon of psychiatric readmission in the context of Psychosocial Care, from the perspective of readmitted patients in a public psychiatric hospital; understand the process of psychiatric readmission to which the patient is likely to be submitted; investigate the assistance, social and familial scenario and their interference in the phenomenon of psychiatric readmission; explore, together with the patients, the existence of perspectives that envisage other possibilities to repeated psychiatric hospitalizations. Initially, in order to synthesize and analyze the national and international scientific production about the phenomenon of psychiatric readmission in the context of deinstitutionalization, an integrative review of the literature was conducted in research sources of impact. It was found a deficiency of studies that investigate psychosocial variables involved in the problem, as well as an absence of the patient's perspective on the subject. The present study was based on the Psychosocial Care, as a theoretical, practical and ethical reference, and was also guided by psychosocial rehabilitation as an analytical category. The Psychosocial Care emerges in the current context of paradigmatic transition, from the crisis of the scientific rationality´s paradigm, and it is based on the thought of complexity. To collect data, a semi-structured interview was applied to 22 readmitted patients in the investigated hospital, as well as the collection of their social and demographic information contained in their hospital records. Data were submitted to content analysis, through which the following thematic categories we developed: Functions and dysfunctions of hospital treatment: the meanings of psychiatric hospitalization; Outpatient treatment: repeat or innovate?; Medication and its impasses: perceived benefits and limits; Family-ties and embarrassments: a possible coexistence?; The extramural social dimension: building possible places; The time of discharge: what is to come hereafter. From the data analysis, it was found a combination of deficiencies: lack of desirable family support, lack of pleasant work or occupation, difficulties in the appropriation of the living space, lack of support networks or social ties, lack of outpatient care services and assistance´s inefficiency, that result in noncompliance with treatment, including medication treatment. This scenario favors social isolation and contributes to that, in times of crisis, when there is no possibility of acceptance of suffering in t...

O Lar E O Habitar Para Moradores De Serviço Residencial Terapêutico

“…Elas têm a história marcada por longas internações, quando a loucura era sinônimo de exclusão e segregação. ParaMachado (2012), o isolamento social que os pacientes psiquiátricos vivem é tão intenso que, muitas vezes, eles preferem estar internados para evitar a solidão. Nesse sentido, a internação passa a ser moradia, pois eles não tinham perspectivas de vida fora dali.…”

Estudos de modelos para predição de reinternação em saúde mental no Sistema Único de Saúde (SUS)

“…No âmbito da Saúde Mental, Machado (2012) fez um estudo detalhado para analisar o fenômeno da reinternação psiquiátrica no contexto da Atenção Psicossocial, a partir da visão dos pacientes reinternados em um hospital psiquiátrico público. A ideia era compreender o processo de reinternação psiquiátrica ao qual o paciente está sujeito; investigar o cenário assistencial e sócio familiar e suas interferências no fenômeno da reinternação psiquiátrica; explorando, junto aos pacientes, a existência de perspectivas que vislumbram saídas às repetidas internações psiquiátricas.…”