Sentidos construídos sobre a internação em Comunidades Terapêuticas com pessoas em tratamento por uso de drogas

Abstract

Mental health assistance and specifically problematic alcohol and drug use care has been neglected by state policies for a long time. Nowadays, there are different sorts of possible treatments for problematic drug use, however, the current public policies has grown funding for Therapeutic Communities (TC) inpatient treatment. This study aims to comprehend the constructed meanings regarding Therapeutic Communities inpatient treatment experienced by patients whose had been treated by this kind of strategy and now are under treatment on Centro de Átenção Psicosocial-Álcool e Drogas of Ribeirão Preto (CAPS-AD).To achieve this, semi-structured interviews were conducted with people on treatment in a CAPS-AD Ribeirão Preto-SP, who have undergone at least one inpatient experience on Therapeutic Communities. A thematic-categorial analysis was carried out using social constructionist epistemology as reference, taking into account the influence of the long-time, short-time and lived-time in the production of meanings. The discussion held dialogued with the literature on the Brazilian psychiatric reform. The project was approved by the Research Ethics Committee, respecting the ethical criteria of Resolution No. 466 of December 12, 2012. The presented analysis and results were based on 10 interviews, being constructed four categories: 1) Therapeutic Communities and equipment of psychosocial care network; 2) Memorable moments as triggers of inpatient admission decision and their expectations; 3) Operation of Therapeutic Communities; and 4) The output of the Therapeutic Community: decision and experiences in society. The public policies fostering funding for TCs, has invested in an understudied model and acts in contradiction with the guidelines of the Brazilian Psychiatric Reform. The TCs works only with the perspective of abstinence treatment, proposing as key interventions: domestic, field (larbotheraphy) and spiritual activities. There is a social construction based on moral-religious and legal discourse that extended inpatient stays would be a resolution for problems related to drug use, and this has made the CTs privileged by public funding. However, TCs users and their family members are constantly deceived and exposed to violence (coercion, enforcement and punishment). It has disregarded the complexity of this field, impacting the way drug users are described and describe themselves.

Research as social practice: the researcher and the "other" in knowledge production

“…Com isto não sugerimos que se abandone o foco na linguagem, mas destacamos que algumas vezes se faz necessário que o conteúdo ganhe destaque, considerando posicionamentos políticos importantes no contexto do estudo. Pesquisa que buscava descrever os sentidos sobre a experiência de internação em comunidades terapêuticas (CT) produzidos com usuários de drogas pri-orizou o foco no conteúdo em detrimento do modo de funcionamento da linguagem, a fim de que os produtos do estudo fortalecessem as denúncias que vinham sendo feitas em relação ao tratamento em CTs por usuários, pela mídia, por conselhos de profissão e pelo Ministério Público (Melo, 2016). Assim, o estudo partiu de um posicionamento claro a favor de serviços comunitários e abertos, como preconizados pela Reforma Psiquiátrica e pelo modelo de redução de danos e levou em consideração o momento histórico em que o país se encontrava, em que estava sendo realizado grande investimento financeiro federal em instituições fechadas, com características totais e asilares.…”