A rede de atenção à saúde mental: Um estudo acerca dos limites e possibilidades no município de Campina Grande - Paraíba

Abstract

Historically, a serie of changes have occurred in mental health care standards in Brazil, through the Psychiatric Reform as a development of the Brazilian Health Reform, reforms that have been a major milestone in the construction of public health and mental health politics, representing significant achievements for civil society. Among them is the Federal Law 10.216 / 01, which incorporated the guidelines of the Psychiatric Reform, from this we also have the institution of the Psychosocial Care Network (RAPS) through Ordinance No. 3.088 / 11, which provides for the expansion and articulation of psychosocial care services and actions in the country for people with suffering or mental disorders. However, despite the real advances, the commodification of social politics, including mental health, has prevailed in our context, given the neoliberal offensive that has been with us since the 1990s. In this sense, the present study had as its general objective to analyze the limits and possibilities found for the implementation of the Psychosocial Care Network (RAPS) in the city of Campina Grande - PB in the current context. Therefore, it was necessary to: understand the relationship between what is foreseen by the specific laws of protection and assistance of people with mental disorders, and what has been implemented; identify the organizational configuration of the shared mental health network; and to clarify the limits and possibilities for the development of the mental health care model based on the Psychosocial Care Network (RAPS). The method of reality analysis that seemed pertinent to us was the dialectical critic. Thus, a literature review of the main study categories (Counter-Reform and Psychiatric Reform), documentary research of the main legislations of the Mental Health Policy, and interviews with a qualitative approach were conducted in order to unveil: how has RAPS been conformed in particularity of the municipality of Campina Grande-PB? What are the limits and possibilities for its construction? Our investigative process took place between April and May 2019, at the Psychosocial Care Center III - REVIVER, in the city of Campina Grande - PB, because it is an important service modality in the organization of an effective substitute network for the hospital. Psychiatric and the advance of the Psychiatric Reform Process, by providing clinical care 24 hours / day. We counted on the participation of 07 (seven) professionals of the referred institution, whose areas of expertise were: social work, physical education, psychology, nursing / coordination and the administrative sector. The main results achieved with regard to the limits of local RAPS were: assistance links that seem to be weakened, showing a disarticulation process between the different devices / professionals that make up this network compromising the process of intersectoriality, a fundamental strategy in the construction of health projects. health, solidarity and social participation, making subjects active in health production; the precariousness of the work process of professionals, added to an inadequate physical structure, making it impossible to promote territorial and integral care actions, etc., reflecting a clear lack of responsibility of the public power, in relation to the management of quality psychosocial care. Regarding the possibilities, the main point highlighted was the commitment of professionals, specifically CAPSIII-Reviver, who has been struggling daily to resist and overcome the limitations of this process of strengthening the network and thus contributing to the subjective restructuring of the user and the respect for its uniqueness. Therefore, despite the advances that come from the Psychiatric Reform process in Campina Grande-PB, which enabled the construction of a psychosocial care network considered one of the best equipped in the country, we consider that currently the municipality's RAPS is weakened / disjointed in many ways.