Por uma Reforma Psiquiátrica Antimanicomial: o papel estratégico da Atenção Básica para um projeto de transformação social

Detalhes bibliográficos
Autor(a) principal: Rosa , Elisa Zaneratto
Data de Publicação: 2016
Tipo de documento: Tese
Idioma: por
Título da fonte: Biblioteca Digital de Teses e Dissertações da PUC_SP
Texto Completo: https://tede2.pucsp.br/handle/handle/18816
Resumo: This study analyzes challenges for the advancement of the anti-asylum radicality in the Brazilian psychiatric reform, standing for the strategic role of Primary Health Care and the inter-sector policies of access to rights. It is a development of the work carried out by the Pró-PET-Saúde, between the years of 2012 and 2104, through the agreement signed by PUCSP and the Health Technical Supervision in FÓ/Brasilândia. Resorting to theoretical references from the Italian Psychiatric Reform, the anti-asylum radicality is placed in the rupture within the concept of mental illness, whose determinations refer back to the socio-economic system. As a consequence, it is recommended that the strategies for care be directed to the transformation of the relationships between society and madness. The study aims to analyze, in Singular Therapeutic Projects of the community care to mental health, the overcoming of the concept of mental illness, the transformation of therapeutic itinerary of patients and the obstacles for the production of interventions derived from the territory and the community, emphasizing the role of Primary Health Care. Four cases in the realms of PET-Saúde and associated to the population of one of the Primary Health Care Units of Brasilândia were selected. Data was analyzed in the light of a categorization that accounted for the circuit of medicalization/hospital admission and the examination and questioning of the concept behind mental illness in the ways these cases were handled by the network; the social vulnerability, the intersections of gender and race, and the impacts in therapeutic projects; the relevance of the work in the experience of pain of the subjects and the answers offered by the services. The methodology was supported by the fundaments of Sociohistorical Psychology and the materialistic historical dialectical method. The analysis acknowledges historicity as a fundamental category and aims to comprehend the care in mental health offered by the network from its multiple constituent determinations. Throughout this process, the analysis of the historical development of the Psychiatric Reform in Brazil signals towards the advancement of the substitutive network and, at the same time, the effects of the neoliberal pacts for the integral and continuous care in mental health. The comprehension of the conditions of the territory highlights important indexes of poverty, vulnerability and violence, accompanied by the precarious state of inter-sectorial policies for the enforcement of rights in the region. With regards to the implementation of the mental health network in the territory, it is noticed that the administration models imposed a discontinuity with consequences in the consolidation of the matrix support. In the therapeutic projects, these processes stand out in the obstacles to a radical rupture within the concept of mental illness and the production of interventions centralized in the territory, which associates with the acknowledgement of the singular features in the production of the care. The field of Primary Health Care, especially through the Family Health Strategy, presents itself as a powerful item in the offering of guided orientations to the needs of the subjects from their concrete living conditions, impacting the community and articulating inter-sectorial networks. In order to do so, the study points towards the need to invest in the qualification of the mental health care carried out by Primary Health Care, understanding the need to prioritize, in the therapeutic projects, the relationship between society and madness, towards a commitment with the historical process of social transformation
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spelling Furtado, Odairhttp://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4777490P7Rosa , Elisa Zaneratto2016-08-08T14:35:18Z2016-03-30Rosa , Elisa Zaneratto. Por uma Reforma Psiquiátrica Antimanicomial: o papel estratégico da Atenção Básica para um projeto de transformação social. 2016. 380 f. Tese (Doutorado em Psicologia: Psicologia Social) - Programa de Estudos Pós-Graduados em Psicologia: Psicologia Social, Pontifícia Universidade Católica de São Paulo, São Paulo, 2016.https://tede2.pucsp.br/handle/handle/18816This study analyzes challenges for the advancement of the anti-asylum radicality in the Brazilian psychiatric reform, standing for the strategic role of Primary Health Care and the inter-sector policies of access to rights. It is a development of the work carried out by the Pró-PET-Saúde, between the years of 2012 and 2104, through the agreement signed by PUCSP and the Health Technical Supervision in FÓ/Brasilândia. Resorting to theoretical references from the Italian Psychiatric Reform, the anti-asylum radicality is placed in the rupture within the concept of mental illness, whose determinations refer back to the socio-economic system. As a consequence, it is recommended that the strategies for care be directed to the transformation of the relationships between society and madness. The study aims to analyze, in Singular Therapeutic Projects of the community care to mental health, the overcoming of the concept of mental illness, the transformation of therapeutic itinerary of patients and the obstacles for the production of interventions derived from the territory and the community, emphasizing the role of Primary Health Care. Four cases in the realms of PET-Saúde and associated to the population of one of the Primary Health Care Units of Brasilândia were selected. Data was analyzed in the light of a categorization that accounted for the circuit of medicalization/hospital admission and the examination and questioning of the concept behind mental illness in the ways these cases were handled by the network; the social vulnerability, the intersections of gender and race, and the impacts in therapeutic projects; the relevance of the work in the experience of pain of the subjects and the answers offered by the services. The methodology was supported by the fundaments of Sociohistorical Psychology and the materialistic historical dialectical method. The analysis acknowledges historicity as a fundamental category and aims to comprehend the care in mental health offered by the network from its multiple constituent determinations. Throughout this process, the analysis of the historical development of the Psychiatric Reform in Brazil signals towards the advancement of the substitutive network and, at the same time, the effects of the neoliberal pacts for the integral and continuous care in mental health. The comprehension of the conditions of the territory highlights important indexes of poverty, vulnerability and violence, accompanied by the precarious state of inter-sectorial policies for the enforcement of rights in the region. With regards to the implementation of the mental health network in the territory, it is noticed that the administration models imposed a discontinuity with consequences in the consolidation of the matrix support. In the therapeutic projects, these processes stand out in the obstacles to a radical rupture within the concept of mental illness and the production of interventions centralized in the territory, which associates with the acknowledgement of the singular features in the production of the care. The field of Primary Health Care, especially through the Family Health Strategy, presents itself as a powerful item in the offering of guided orientations to the needs of the subjects from their concrete living conditions, impacting the community and articulating inter-sectorial networks. In order to do so, the study points towards the need to invest in the qualification of the mental health care carried out by Primary Health Care, understanding the need to prioritize, in the therapeutic projects, the relationship between society and madness, towards a commitment with the historical process of social transformationEsta pesquisa analisa desafios para o avanço da radicalidade antimanicomial da Reforma Psiquiátrica brasileira, defendendo o papel estratégico da Atenção Básica e das políticas intersetoriais de acesso a direitos. Ela é um desdobramento do trabalho realizado pelo Pró-PET-Saúde, entre os anos de 2012 e 2014, por meio do convênio firmado entre a PUCSP e a Supervisão Técnica de Saúde da FÓ/Brasilândia. Resgatando referências teóricas da Reforma Psiquiátrica italiana, a radicalidade antimanicomial é localizada na ruptura com a concepção de doença mental, cujas determinações remontam ao sistema socioeconômico. Em decorrência, preconiza-se que as estratégias de cuidado estejam orientadas para a transformação da relação entre sociedade e loucura. A pesquisa objetivou analisar, em Projetos Terapêuticos Singulares da rede comunitária de atenção em saúde mental, a superação da concepção de doença mental, a transformação dos itinerários terapêuticos dos usuários e os obstáculos para a produção de intervenções a partir do território e da comunidade, com ênfase no papel da Atenção Básica. Foram selecionados quatro casos acompanhados no percurso do PET-Saúde, pertencentes à população adstrita à região de uma Unidade Básica de Saúde da Brasilândia. Os dados foram analisados a partir de uma categorização que considerou o circuito medicalização/internação e a problematização da concepção de doença mental na abordagem dos casos pela rede; a vulnerabilidade social, as intersecções gênero e raça e seus impactos nos projetos terapêuticos; a relevância do trabalho na experiência de sofrimento dos sujeitos e as respostas ofertadas pelos serviços. O percurso metodológico apoiou-se nos fundamentos da Psicologia Sócio-Histórica e do método materialista histórico dialético. Reconhecendo a historicidade como categoria fundamental, a análise buscou apreender o cuidado em saúde mental ofertado pela rede, a partir de suas múltiplas determinações constitutivas. Nesse processo, a leitura da trajetória histórica da Reforma Psiquiátrica no Brasil sinaliza o avanço da rede substitutiva e, ao mesmo tempo, os efeitos dos pactos neoliberais para a integralidade e a continuidade do cuidado em saúde mental. A apreensão das condições do território salienta importantes índices de pobreza, vulnerabilidade e violência, acompanhados pela precariedade de políticas intersetoriais de garantia de direitos na região. Do ponto de vista da implantação da rede de saúde mental no território, destacam-se os modelos de gestão que impuseram uma descontinuidade, com desdobramentos na consolidação do apoio matricial. Nos projetos terapêuticos, esses processos se singularizam nos obstáculos à ruptura radical com a concepção de doença mental e à produção de intervenções centradas no território, o que convive com o reconhecimento das singularidades na produção do cuidado. O campo da Atenção Básica, especialmente por meio da Estratégia Saúde da Família, apresenta-se como potente para a oferta de intervenções orientadas às necessidades dos sujeitos, a partir de suas condições concretas de existência, impactando a comunidade e articulando redes intersetoriais. Para tanto, a pesquisa aponta a necessidade de investimentos voltados à qualificação do cuidado em saúde mental pela Atenção Básica, entendendo a necessidade de priorizar nos projetos terapêuticos a relação entre sociedade e loucura, na direção do compromisso com o processo histórico de transformação socialapplication/pdfhttp://tede2.pucsp.br/tede/retrieve/38135/Elisa%20Zaneratto%20Rosa.pdf.jpgporPontifícia Universidade Católica de São PauloPrograma de Estudos Pós-Graduados em Psicologia: Psicologia SocialPUC-SPBrasilFaculdade de Ciências Humanas e da SaúdeReforma PsiquiátricaLuta antimanicomialAtenção básicaPsychiatric ReformAnti-asylum fightPrimary health careCNPQ::CIENCIAS HUMANAS::PSICOLOGIA::PSICOLOGIA SOCIALPor uma Reforma Psiquiátrica Antimanicomial: o papel estratégico da Atenção Básica para um projeto de transformação socialTowards an Anti-Asylum Psychiatric Reform: the strategic role of Primary Health Care for a project of social transformationinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesisinfo:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da PUC_SPinstname:Pontifícia Universidade Católica de São Paulo (PUC-SP)instacron:PUC_SPTEXTElisa Zaneratto Rosa.pdf.txtElisa Zaneratto Rosa.pdf.txtExtracted texttext/plain952819https://repositorio.pucsp.br/xmlui/bitstream/handle/18816/4/Elisa%20Zaneratto%20Rosa.pdf.txt29d3717834a65135868afc8309658f5aMD54LICENSElicense.txtlicense.txttext/plain; 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dc.title.por.fl_str_mv Por uma Reforma Psiquiátrica Antimanicomial: o papel estratégico da Atenção Básica para um projeto de transformação social
dc.title.alternative.eng.fl_str_mv Towards an Anti-Asylum Psychiatric Reform: the strategic role of Primary Health Care for a project of social transformation
title Por uma Reforma Psiquiátrica Antimanicomial: o papel estratégico da Atenção Básica para um projeto de transformação social
spellingShingle Por uma Reforma Psiquiátrica Antimanicomial: o papel estratégico da Atenção Básica para um projeto de transformação social
Rosa , Elisa Zaneratto
Reforma Psiquiátrica
Luta antimanicomial
Atenção básica
Psychiatric Reform
Anti-asylum fight
Primary health care
CNPQ::CIENCIAS HUMANAS::PSICOLOGIA::PSICOLOGIA SOCIAL
title_short Por uma Reforma Psiquiátrica Antimanicomial: o papel estratégico da Atenção Básica para um projeto de transformação social
title_full Por uma Reforma Psiquiátrica Antimanicomial: o papel estratégico da Atenção Básica para um projeto de transformação social
title_fullStr Por uma Reforma Psiquiátrica Antimanicomial: o papel estratégico da Atenção Básica para um projeto de transformação social
title_full_unstemmed Por uma Reforma Psiquiátrica Antimanicomial: o papel estratégico da Atenção Básica para um projeto de transformação social
title_sort Por uma Reforma Psiquiátrica Antimanicomial: o papel estratégico da Atenção Básica para um projeto de transformação social
author Rosa , Elisa Zaneratto
author_facet Rosa , Elisa Zaneratto
author_role author
dc.contributor.advisor1.fl_str_mv Furtado, Odair
dc.contributor.authorLattes.fl_str_mv http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4777490P7
dc.contributor.author.fl_str_mv Rosa , Elisa Zaneratto
contributor_str_mv Furtado, Odair
dc.subject.por.fl_str_mv Reforma Psiquiátrica
Luta antimanicomial
Atenção básica
topic Reforma Psiquiátrica
Luta antimanicomial
Atenção básica
Psychiatric Reform
Anti-asylum fight
Primary health care
CNPQ::CIENCIAS HUMANAS::PSICOLOGIA::PSICOLOGIA SOCIAL
dc.subject.eng.fl_str_mv Psychiatric Reform
Anti-asylum fight
Primary health care
dc.subject.cnpq.fl_str_mv CNPQ::CIENCIAS HUMANAS::PSICOLOGIA::PSICOLOGIA SOCIAL
description This study analyzes challenges for the advancement of the anti-asylum radicality in the Brazilian psychiatric reform, standing for the strategic role of Primary Health Care and the inter-sector policies of access to rights. It is a development of the work carried out by the Pró-PET-Saúde, between the years of 2012 and 2104, through the agreement signed by PUCSP and the Health Technical Supervision in FÓ/Brasilândia. Resorting to theoretical references from the Italian Psychiatric Reform, the anti-asylum radicality is placed in the rupture within the concept of mental illness, whose determinations refer back to the socio-economic system. As a consequence, it is recommended that the strategies for care be directed to the transformation of the relationships between society and madness. The study aims to analyze, in Singular Therapeutic Projects of the community care to mental health, the overcoming of the concept of mental illness, the transformation of therapeutic itinerary of patients and the obstacles for the production of interventions derived from the territory and the community, emphasizing the role of Primary Health Care. Four cases in the realms of PET-Saúde and associated to the population of one of the Primary Health Care Units of Brasilândia were selected. Data was analyzed in the light of a categorization that accounted for the circuit of medicalization/hospital admission and the examination and questioning of the concept behind mental illness in the ways these cases were handled by the network; the social vulnerability, the intersections of gender and race, and the impacts in therapeutic projects; the relevance of the work in the experience of pain of the subjects and the answers offered by the services. The methodology was supported by the fundaments of Sociohistorical Psychology and the materialistic historical dialectical method. The analysis acknowledges historicity as a fundamental category and aims to comprehend the care in mental health offered by the network from its multiple constituent determinations. Throughout this process, the analysis of the historical development of the Psychiatric Reform in Brazil signals towards the advancement of the substitutive network and, at the same time, the effects of the neoliberal pacts for the integral and continuous care in mental health. The comprehension of the conditions of the territory highlights important indexes of poverty, vulnerability and violence, accompanied by the precarious state of inter-sectorial policies for the enforcement of rights in the region. With regards to the implementation of the mental health network in the territory, it is noticed that the administration models imposed a discontinuity with consequences in the consolidation of the matrix support. In the therapeutic projects, these processes stand out in the obstacles to a radical rupture within the concept of mental illness and the production of interventions centralized in the territory, which associates with the acknowledgement of the singular features in the production of the care. The field of Primary Health Care, especially through the Family Health Strategy, presents itself as a powerful item in the offering of guided orientations to the needs of the subjects from their concrete living conditions, impacting the community and articulating inter-sectorial networks. In order to do so, the study points towards the need to invest in the qualification of the mental health care carried out by Primary Health Care, understanding the need to prioritize, in the therapeutic projects, the relationship between society and madness, towards a commitment with the historical process of social transformation
publishDate 2016
dc.date.accessioned.fl_str_mv 2016-08-08T14:35:18Z
dc.date.issued.fl_str_mv 2016-03-30
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/doctoralThesis
format doctoralThesis
status_str publishedVersion
dc.identifier.citation.fl_str_mv Rosa , Elisa Zaneratto. Por uma Reforma Psiquiátrica Antimanicomial: o papel estratégico da Atenção Básica para um projeto de transformação social. 2016. 380 f. Tese (Doutorado em Psicologia: Psicologia Social) - Programa de Estudos Pós-Graduados em Psicologia: Psicologia Social, Pontifícia Universidade Católica de São Paulo, São Paulo, 2016.
dc.identifier.uri.fl_str_mv https://tede2.pucsp.br/handle/handle/18816
identifier_str_mv Rosa , Elisa Zaneratto. Por uma Reforma Psiquiátrica Antimanicomial: o papel estratégico da Atenção Básica para um projeto de transformação social. 2016. 380 f. Tese (Doutorado em Psicologia: Psicologia Social) - Programa de Estudos Pós-Graduados em Psicologia: Psicologia Social, Pontifícia Universidade Católica de São Paulo, São Paulo, 2016.
url https://tede2.pucsp.br/handle/handle/18816
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dc.publisher.none.fl_str_mv Pontifícia Universidade Católica de São Paulo
dc.publisher.program.fl_str_mv Programa de Estudos Pós-Graduados em Psicologia: Psicologia Social
dc.publisher.initials.fl_str_mv PUC-SP
dc.publisher.country.fl_str_mv Brasil
dc.publisher.department.fl_str_mv Faculdade de Ciências Humanas e da Saúde
publisher.none.fl_str_mv Pontifícia Universidade Católica de São Paulo
dc.source.none.fl_str_mv reponame:Biblioteca Digital de Teses e Dissertações da PUC_SP
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repository.name.fl_str_mv Biblioteca Digital de Teses e Dissertações da PUC_SP - Pontifícia Universidade Católica de São Paulo (PUC-SP)
repository.mail.fl_str_mv bngkatende@pucsp.br||rapassi@pucsp.br
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