A dimensão ético política da reforma psiquiátrica

Abstract

The object of study of this Thesis is the Mental Health Policy, and its objective is to discuss the new model of mental health care in force in Brazil, in its ethical-political dimension. To this end, it sought to analyze the conditions, advances and obstacles to the implementation of Psychiatric Reform in the country, comparing the experiences of Belo Horizonte-MG and Salvador-BA, two Brazilian metropolises - emphasizing the influence of professionals in this area. The choice of the city of Belo Horizonte is justified by housing one of the most successful experiences of implementation of Psychiatric Reform in the country. Already in Salvador, the advance in this perspective occurs more slowly and problematically. The process of Brazilian Psychiatric Reform, triggered in the late 1970s, from mobilizations within the civil society, is linked to other movements and achievements, in the international context, overcoming the Asilar Model. Established within the framework of the French Revolution, this Model was a response to the social presence of “madness”. Law 10.216 / 01 marks the achievement in the legal field of Psychiatric Reform, idealized and gestated within the Antimanicomial Movement, which entered the Brazilian scene from 1987, bringing together workers, users of Mental Health Services and family, around the overcoming project of the Asilar Model. The general objective of analyzing the conditions and progress of the implementation of the Psychiatric Reform, comparing the experiences of Salvador and Belo Horizonte and emphasizing the influence of professionals in this area was divided into the following specific objectives: to analyze the perception of professionals about change. of paradigm; analyze the difficulties of professionals in the operationalization of the new model and identify the limits in the methodological theoretical training, technical assistance and institutional policy for the exercise of the new model. The assumptions were that the understanding of the subjects has a decisive influence on the processes of change and that in the processes of institutionalization of new models, the consolidation of transformations in the socio-cultural dimension (and, consequently, the scope of the ethical-political dimension) is the most complex aspect.. The study sought support in the Extended Theory of the State of Italian Antonio Gramsci, focusing on its concept of Organic Intellectual. A qualitative research was carried out, having as Method, the Dialectical Materialism, of analytical - descriptive nature. The research had as empirical field the Psychosocial Care Network of the cities of Salvador and Belo Horizonte. The research subjects were the representatives of the various professional segments that make up the RAPS (Psychosocial Care Network) of the Municipality, as well as users of the services. Narrative interviews, direct observation, bibliographic and documentary analysis were conducted. From the broad analysis undertaken, the thesis on the positive or negative contribution of professionals, from their training / culture and ethical - political commitment, to the success of the Psychiatric Reform was proved. However, the analysis of the experiences recorded here highlights how sociopolitical conditions also significantly influence the results of the process.