Cidadania e as práticas de cuidado na contemporaneidade da reforma psiquiátrica brasileira: paradoxos e contradições

Abstract

This thesis has as goal of identifying how the sense and meaning of being a person with mental health is configured on the Brazilian Psychiatric Reform, on the routine operations in one Center of Psychosocial Care (Centro de Atenção Psicossocial-CAPS) and on a local community association. It’s a theoretical, documentary and qualitative investigation that triangulates methods and analyzes different epistemologies, which are present in the concept of wellbeing and mental health problems, including many rival, paradoxical, contradictory and complementary visions. The work was made from different perspectives, starting with one theoretical and conceptual study of the significance of being a mental health Patient, using the perspectives of the asylum clinic system and the psychosocial care clinic; it considers the perspective of human rights in national and international official documents, highlighting those that come from the wide range of civil society organizations and from the National Conferences on Mental Health reports and on the praxis of one Center of Psychosocial Care and one local Family and Users Association for Mental Health. The work as a whole was submitted to a hermeneutic-dialectic analysis. Is not possible to think of mental health without inclusion. This refers to the finding that a patient with mental health disorder is relational since it does not exist out side of the territory of a social group. Considering the analyzed data it was possible to identify that there are difficulties of different orders in the inclusion of practices with citizenship in the assistance: the presence of a vertical model with the supremacy of one discipline to the detriment of others, focus on the signals and symptoms and drug treatment, protective attitudes that implicitly refer to disqualify people under treatment, domination on humanitarian character actions besides the appreciation of inclusive actions of rescue of citizenship. It is concluded that the categories that founded Psychiatry and human rights, such as, the principle of rationality and the principle of equality are nuclear of the definition of the social place occupied by people with mental disorder; also associated with difficulties to achieve the assumptions of the human being existence.