/pdf/adeus-ao-trabalho-ensaio-sobre-as-metamorfoses-e-a-1kwytr40uw.pdf

Adeus ao Trabalho? Ensaio sobre as metamorfoses e a centralidade do mundo do trabalho

This article presents a preliminary discussion of potential methodological tools for qualitative research on the Network of Referral Centers for Psycho-Social Care (CAPS) in the Brazilian Unified Health System (SUS). The relevance of mental health within the field of public health is examined. The study focuses on the high prevalence of mental disorders and the disproportionate lack of studies on the interface between mental health and public health. The establishment of an interdisciplinary field between public health and mental health is proposed to meet common needs by achieving similar perspectives in knowledge and practice. A particular group of tools is proposed, emphasizing the importance of reclaiming and guaranteeing the roles of various social actors to shape the assessment process, the need for collecting and standardizing academic studies on the topic, and the importance of promoting a new research field focusing on public health policies to support policymakers, managers, and health teams in reshaping their practices.

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Entre a saúde coletiva e a saúde mental: um instrumental metodológico para avaliação da rede de Centros de Atenção Psicossocial (CAPS) do Sistema Único de Saúde

The article takes a look at Brazilian Psychiatric Reform over the past decade, after the approval of Federal Law 10.216/2001 and seeks to elicit long overdue discussion about the pressing challenges that Brazilian Psychiatric Reform needs to tackle to promote or review the long-desired utopia of "full citizenship for all in a society without asylums." Is the Reform showing signs of exhaustion? The redirection of the care model for Mental Health in Brazil from the hospital to the community over the past decade is an undeniable achievement. Taking the use of psychoactive substances as the scope of policy and intervention, this incorporates complex demands that the current Crack drama makes it more urgent to question its history, its limits, its power. What will keep the flame alight of a successful movement that, surprisingly, has resisted the force of time and stigma in the ten years since the Law was enacted? These and other questions need to be worked on. It is time to recycle the focus of assessment and analysis in order to identify what threatens its vitality. This is the challenge to which the writer and debaters will be enjoined to contribute.

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Um balanço da reforma psiquiátrica brasileira: instituições, atores e políticas

Resumo O artigo realiza um percurso historico e epistemologico da construcao das politicas publicas de saude mental e atencao psicossocial a partir do SUS. Para tanto, propoe uma abordagem que identifica as acoes e as estrategias relacionadas ao aspecto da participacao social na construcao das politicas, um dos principios fundantes do SUS, e procurando demarcar a importância desta na trajetoria especifica do processo de reforma psiquiatrica no Brasil. Posteriormente, destaca tambem a originalidade e a importância da atuacao que teve como meio e como fim a cultura, no sentido de nao restringir a reforma psiquiatrica a uma transformacao limitada aos servicos e a saude em sentido estrito, ressaltando o principio da construcao de um novo lugar social para a loucura. Por fim, faz um acompanhamento historico da promulgacao das politicas de saude mental, identificando as iniciativas mais importantes e seus impactos na transformacao do modelo assistencial e encerra com o questionamento sobre a reorientacao conservadora que no momento se impoe.

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Psychiatric reform in the SUS and the struggle for a society without asylums.

Introduction: Studies have shown important gender differences among drug (including crack) users related to: drug use patterns; health risks and consequences; criminal involvement; and service needs/use. Crack use is prevalent in Brazil; however, few comparative data by sex exist. We examined and compared by sex key drug use, health, socio-economic indicators and service use in a bi-city sample of young (18–24 years), regular and marginalized crack users in Brazil. Methods: Study participants (total n = 159; n = 124 males and n = 35 females) were recruited by community-based methods from impoverished neighborhoods in Rio de Janeiro and Salvador. Assessments occurred by an anonymous interviewer-administered questionnaire and serum collection for blood-borne virus testing between November 2010 and June 2011. Descriptive statistics and differences for key variables by sex were computed; in addition, a ‘chi-squared automatic interaction detector’ (‘CHAID’) analysis explored potential primary factors differentiating male and female participants. Results: Most participants were non-white, and had low education and multiple income sources. More women had unstable housing and income from sex work and/or panhandling/begging, whereas more men were employed. Both groups indicated multi-year histories of and frequent daily crack use, but virtually no drug injection histories. Men reported more co-use of other drugs. More women were: involved in sex-for-drug exchanges; Blood-Borne Virus (BBV) tested and HIV+. Both groups reported similar physical and mental health patterns; however women more commonly utilized social or health services. The CHAID analysis identified sex work; paid work; begging/panhandling; as well as physical and mental health status (all at p < 0.05) as primary differentiating factors by sex. Conclusions: Crack users in our study showed notable differences by sex, including socio-economic indicators, drug co-use patterns, sex risks/work, BBV testing and status, and service utilization. Results emphasize the need for targeted special interventions and services for males and female crack users in Brazil.

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Exploring sex differences in drug use, health and service use characteristics among young urban crack users in Brazil

Once the compfex sociaL process ofPsychiatric Reformation, materiaLized in BraziL as MentaL HeaLth PoLicy, invoLves a tkep transfOrmation in mentaL heaLth as...

A Estratégia Atenção Psicossocial: desafio na prática dos novos dispositivos de Saúde Mental

This research describes an approach to Brazilian Psychiatric Reform where focus the analysis axis on Paulo Amarante’s four dimensions for characterizing Psychiatric Reform as a Complex Social Process. Amarante’s first dimension is concerned with the judicial-political dimension (renamed here as the politic dimension) and the historical Psychiatric Reform path. With these dimension one can point out tensions and conflicts
of participants’ actions and thereby call into question the relationship between government and society. Amarante’s second dimension is epistemology, where the aim is to establish a relation and a parallel between paradigm transition in science – as purposed for many critical authors from the perspective of modern rational science – and the epistemological rupture in traditional psychiatric. The third dimension focuses on technical assistance. The aim is to create a map and an analysis of the CAPS’s
principal concepts of health care production. Here, health care does not simply refer to the health care services, but is viewed as a strategy that produces a rupture within the hegemonic assistance model. At the fourth, social-cultural dimension the aim is to present the possibilities of creating a transformation in the professional’s training process by examining the mainly responsible for the construction of a new social place for madness. The question is explored through reflection about the author’s work
developed at the university with students and new professionals. This research shows that the hypothesis of the Psychiatric Reform, for its complexity, diversity ah recovery, can not be taken as the transformation of the structure of health care services or as change in the institution. Its nature is much more amplified. Psychiatric Reform is a civilizing process. It is a process that, in the daily encounter with those who suffer – sometimes those who suffer intensely – produces a rupture with hegemonic models and
thereby invents different modes of care by diversifying actions and connecting with the territory, thereby inventing possibilities for sociability, social values, and ethics which, in turn, creates the possibility of another world.

/pdf/rupturas-e-encontros-desafios-da-reforma-psiquiatrica-10b972pz13.pdf

Rupturas e encontros: desafios da reforma psiquiátrica brasileira

The use of crack cocaine has given rise to an intense discussion in society. Research has contributed to the characterization of users and the negative consequences of its use. However, few studies have conducted in-depth study of the social and cultural contexts in which crack cocaine is used. Thus, this study seeks to discuss the ritual of crack cocaine use and its social and health consequences for the user. It is a qualitative study developed in the Psychosocial Care Centers for Alcohol and Drugs (Portuguese acronym: Caps-ad). The individuals were selected in two groups of key-informants: crack cocaine users undergoing treatment and health professionals. Data was obtained by means of semi-structured interviews. The results revealed that the use of crack cocaine is not dissociated with the current organizational structure of society. There is a link between the use of this substance and the social organization for its use. By using crack cocaine, the individuals try to be part of a consumer market, actively participating in what society perceives as new. The forms and locations of use are directly related to users' health, making it necessary for healthcare services to detect, approach and make health interventions in these locations of use.

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Ritual de consumo do crack: aspectos socioantropológicos e repercussões para a saúde dos usuários

The present work intends to analyze some of the Governmental decrees of the National Mental Health Policy implemented in the country in the 1990/2006 period, so they establish themselves in important devices to induce changes in Mental Healths care model. It indicates to the most relevant document and highlights its consequences and problems for the construction of psychosocial care. It was concluded at the end that the advancement of Brazilian Psychiatric Reformation is increasingly linked to the construction and consolidation of the Unified Health System (SUS). In this way, the health managers, along with the others segments of society, had started to be important actors in the use of the resources contained in the new legislation actually focused on the construction of a new way of care in the mental health that makes possible a new position of the citizen in the world, considering its subjective, social and cultural dimension.

https://www.scielo.br/pdf/pe/v15n1/a03v15n1.pdf

Além das portarias: desafios da política de saúde mental

O presente ensaio tem por objetivo refletir sobre os termos Atencao Psicossocial e Atencao Basica como proposicoes que se apresentam como uma mudanca de paradigma, articulando com o conceito de territorio que surge aqui como elemento comum aos dois campos, especialmente no que concerne a producao de cuidado que nele se faz e em rede. Esta perspectiva implica em um olhar para a diversidade social e cultural dos diferentes locais como um aspecto essencial para articular as acoes de saude e de saude mental, no espaco onde a vida acontece como ela e, em sua plenitude. Implica, tambem, no caso da Atencao Psicossocial, em superar logicas de exclusao e aniquilamento das diferencas que incidem sobre os nomeados “loucos”, e tambem, sobre todos que explicitam modos diversos de existir. Palavras-chave: Atencao Psicossocial; Atencao Basica; Territorio: Reforma Psiquiatrica; Reforma Sanitaria.

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Silvio Yasui

Papers

A Estratégia Atenção Psicossocial: desafio na prática dos novos dispositivos de Saúde Mental

Rupturas e encontros: desafios da reforma psiquiátrica brasileira

Ritual de consumo do crack: aspectos socioantropológicos e repercussões para a saúde dos usuários

Além das portarias: desafios da política de saúde mental

Atenção psicossocial e atenção básica: a vida como ela é no território / Psychosocial care and primary care: life as territory in the field