Do manicômio ao CAPSI: o percurso brasileiro para as políticas de saúde mental infantil

Abstract

The objective of this study is to analyze the historical setting of the development of mental health policies for children in Brazil, from initial initiatives to the implementation of CAPSi. The study focuses on the context of Natal / RN, which was chosen due to the recent inauguration of CAPSi, an innovative mental health service, aimed at replacing the traditional medical asylum model. The specific objectives of the study are to: a) collect and analyze, from the perspective of children's mental health, the documents produced from the National Conferences of Health (CNS) and the National Conference of Mental Health (CNSM); b) analyze the historical setting that led to the creation of CAPSi in Brazil and the capital of Rio Grande do Norte (RN); c) identify and analyze the practices and discourses used to legitimize actions in CAPSi Natal. To this end, a Foucaultian discourse analysis was carried out on bibliographic data, including research reports, official documents and semi-structured interviews with the officials responsible for the implementation of CAPSi Natal. CNS' reports provide evidence of these as places to discuss children, primarily disabled children, and children diagnosed with severe neurotic and psychotic disorders, even addressing health practices regarding women in labor, as well as policy control of infant mental health. The CNSM already implemented, in the political process of reform of the psychiatric model, paving the way for a direct and effective debate of the CAPSi's deployment project. In Natal, this project comes from the legal demand to face the social problem of substance abuse in the adolescent population. Thanks to the struggle waged by the technicians, the CAPSi Natal was accomplished with a proposal of de-institutionalization and inclusion, taking on effective policy features in mental health for children and youth, which, living through a heritage of exclusion, to find in, the XXI century, privileged space for effective change, also its greatest challenge.