Política de Saúde Mental em Montes Claros: os caminhos e descaminhos da Reforma Psiquiátrica

Abstract

Mental health policy in Brazil has developed in a complex way, being stressed by several sectors. The results of the PR Psychiatric Reform differ in the different regions. In some, there are significant advances, and in others, it still appears discreetly. In some, there are significant advances, and in others, it still appears discreetly. In Montes Claros-MG, for fifty-eight years, the operation of a psychiatric hospital was perpetuated. This research is based on the problem of how the asylum perspective has been overcome, centered on disease and segregation as the main means for the treatment of subjects with psychic suffering, for the (re) construction of human rights in the logic of psychosocial care. We were interested in the historical history of PR in the municipality, but above all, what refers to the development of the mental health policy since the closure of the psychiatric hospital. As a strategy for understanding the object, we start with the juxtaposition of research methods and techniques. We conducted a qualitative study, through which we interviewed the various subjects involved in the field of mental health, especially those who participated in the transition of care models. We also look for documents (minutes of meetings, offices, bills) related to our problem. We use thematic content analysis. We perceive that RP devised the deinstitutionalization as a deconstruction of a logic of excluding mental health care with a view to breaking the centrality of care in the figure of the psychiatric hospital, requiring resources and commitment on the part of the State to enable a Network of services based entirely. However, the leadership that has been conducted by a Minimum State is more focused on deinstitutionalization, by offering scrapped services with structural obstacles to meeting demands. In Montes Claros, the services that make up the Psychosocial Care Network have been implanted in a slow and gradual way; have assumed intermediate rather than substitutive characteristics and reproduce at the local level the difficulties of SUS in Brazil. The shortcomings of this Network reverberated in the non consolidation of a real process of deinstitutionalization of the subject. Essential points of PR were not consolidated in the municipality, such as the expansion and qualification of beds and professionals of general hospitals and the creation of reference points for emergencies and psychiatric emergencies. There was a loss of breath and enthusiasm on the part of the actors who work in the services and even of the population itself in continuing to fight struggles for the expansion of care and the effective rights of people with mental suffering. Despite the numerous challenges, it was possible to perceive that the municipal PR, to a certain extent, has favored a more inclusive and humanized treatment and has expanded spaces of social participation, giving voice to the subjects that historically were silenced. However, we understand that further steps should be taken in defense of an effectively comprehensive anti psychiatric mental health policy.