Da desconstrução do aparato manicomial à implementação da "política pública" de saúde mental CAPS : o caso de Santa Cruz do Sul/RS.

Abstract

The objective of this work is the analysis the process of the Psychiatrist Reform, which started in Brazil during the eighties. Considering a case of study, regarding the implementation of Mental Public Health of Psycho-social care Center (CAPS) in the municipality of Santa Cruz do Sul –RS. Focusing the transformation of assistance to mental health, the new work strategies, the managing of the knowing process, as well as the challenges of multidisciplinary behavior. The used strategy was the speech analysis, used considering the semi-structured techniques of interview, and those of focal group. Five professionals of adult CAPS participated in the research; (a psychiatrist, a psychologist, a social assistant, a technician of nursing, a occupational therapist) and four professionals of the children CAPS (a psychiatrist, a psychologist, a social assistant, and a phone audiologist). The results of this study revealed the limits and transformations occurred during the process of Psychiatry Reform, especially referring to rupturing the epistemological disciplinal and hospital-centered model. Among the limits mentioned, we can highlight the precarious articulation between the Santa Cruz CAPS and the basic health network, the separation between the “technical team” and the “supporting team” the disciplinary hierarchy, which is shown in the psychiatry-concept of the knowledge related. Referring to the changes on the ancient way of treatment, it is clear that there’s a bigger concern about the customer citizenship guaranty, bigger family participation during the treatment, as well as the beginning of the community demystification process concern, regarding “craziness”. One of the biggest concerns of mental health public policy (CAPS), refers to the lack of maturity to the interdisciplinary approach, which, in a way, still portraits the difficulties found about a real understanding of the principles shown in the Psychiatric Reform.