Direitos dos usuários em intenso sofrimento psíquico, na perspectiva dos usuários e dos gestores de CAPS / Rights of users in intense psychic suffering, in the perspective of users and managers of CAPS

Bruno Ferrari Emerich

The Psychosocial Care Centers are reference in the service of mental health treatment. They propose to work towards a perspective of the extended clinic, through the protagonism of the users, which includes the construction and exercise of bigger degrees of autonomy, of rights and co-responsibility on their part. By questioning the concept of autonomy, and its interface with the exercise of rights, this study aims to identify and comprehend the concept of rights of users of CAPS, as from their own voice and of the managers of these services. Builds relevance for such analysis the management concept in the co-management dimension. The contents worked here are from a multicenter study, which a constructivist and interpretive paradigm was used, inserted in the fourth generation qualitative approach, which includes people with greater representation in the selected services (users, workers and managers, as well as students of the multidisciplinary residency and of psychiatry). The field work consisted in intervention groups with the users, in different fields. To survey the empiric material, we made use of the focal group technique (with users and managers) and interviews (with managers), that were audio recorded and later on transformed into verbatim scripts. These initial texts were transformed into narratives by extraction of their argumentation core. In addition, there were records/memories of the intervention group meetings. The data analysis indicates that the exercise of rights is made possible by the emergence of the subjects of rights, which are made singular from the collective, which far exceeds the knowledge of the laws. Analyzing the relationships between the users and managers of CAPS, modulated by biopower, it was possible to learn the formation of a circuit in which users are embedded, in which institutional mechanisms create a defensive response of the user and later on transforms this response into the next target. In the open, total practices produce a form of control over users, and consequently over the exercise of rights on behalf of these, which can generate new forms of chronicity: of the users, the workers, the service and management. Place as crucial, as well, to recognize that the users also conceive the violation of rights through the felt invasion: through auditory hallucinations and persecutory sensation. It is essential that the rights issues are taken up and questioned by the Brazilian RP, at the risk of this catalyst and foundation of the movement becoming mere rhetorical, in the texts and speeches, void of meaning and inexistent in the user life. In this process, the CAPS cam accomplish important functions: articulating hot networks and mediating usufruct rights.

Direitos dos usuários em intenso sofrimento psíquico, na perspectiva dos usuários e dos gestores de CAPS / Rights of users in intense psychic suffering, in the perspective of users and managers of CAPS

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