"The Psychiatric Reform in Cuiabá/MT: an analysis of the work process of the mental health teams" / "A reforma psiquiátrica em Cuiabá/MT: análise do processo de trabalho das equipes de saúde mental"
Alice Guimarães Bottaro de Oliveira
DATA DE PUBLICAÇÃO
The study object of this thesis is the movement for a Psychiatric Reform carried out in the district of Cuiabá (MT), analyzed through the work processes of the teams in charge of mental health outpatient attention and based on a dialectic-Marxist approach. It is understood that the working process, being the foundation of the production manner and human interaction, allows us to analyze all the problems involved in health practices which become effective in a certain concrete and complex reality. These practices represent a synthesis of the multiple socio-historical orders. The movement of Psychiatric Reform in the 70s and 80s in Cuiabá coincided with the growth of the number of hospitals in the private area, determined by the peculiar local socio-economic development process. We can, nowadays, notice the preeminence of private hospitals in the context of mental health assistance in Cuiabá and, at the same time, observe a slight administrative re-organization of the assistance to outpatients although it cannot be compared, in quantity nor quality, to the medical-psychiatric attention model provided by hospital psychiatry. This re-organization seeks to attend to, on a first instance, the present financing rules of the sector. A centralization of the administrative power has been observed together with somehow failing work-bonds for professionals and the absence or restriction of number and professional categories that should be considered essential to achieve a modified pattern of attention to the teams work. Citizenship instrument and purpose of the therapeutic process within the Psychiatric Reform is disassociated from the experience and working organization of professionals and users. The predominant reference to citizenship in the working processes is that of a tutored citizenship. We were not able to observe the problematics of the citizenship condition of the mentally disabled and as the contradictions in the professionals practice simultaneous occurrence of independence restrictions and psycho-social attention were not explored, a certain alienation was detected as far as their work was concerned, which was reduced to task compliance. Medication is the structuring mechanism of all the analyzed practices and the most apparent instruments for the therapeutic approach are psychotropic drugs. The conformation of a new assistance paradigm Psychiatric Reform requires the confrontation with the old psychiatric medicine model, which was not observed in the reality context we studied.
- Modos de subjetivação dos trabalhadores de saúde mental em tempos de Reforma Psiquiátrica
- Critical-discourse analysis of the mental health workers practice within the social context of the psychiatric reform.
- Apoio matricial em saúde mental: possibilidades e limites no contexto da reforma psiquiátrica
- Necessidades em saúde &trabalho das equipes de saúde da família: a dialética do reconhecimento e enfrentamento
- "Mental Health Planning in the Psychiatric Reform Context: a study of Paranas western Region Cities"