"Eu sou uma pessoa e não uma doença": a gestão autônoma de medicação na estratégia saúde da família de um município do interior do Rio Grande do Norte

Abstract

The Brazilian psychiatric reform movement proposes the production of new practices and contexts of interventions \ mental health care based on freedom care and that seek to establish themselves against the hegemonic medicalizing logic, which has produced an epidemic of diagnoses of mental disorders, fruit of the phenomenon of medicalization of life. One of the expressions of this phenomenon is the high prescription rates of psychotropic drugs and the low critical use of these drugs in health services. Therefore, it is urgent in the context of the articulation of psychosocial care with primary health care in Psychosocial Care Networks, to propose elements aligned with non-medicalizing perspectives and seeking an intervention model that favors integral and territorialized care in mental health. In the Family Health Strategy, we have the privileged locus for the production of new care technologies, which favor de-medicalization, empowerment and the production of autonomy of subjects in psychological distress and mental disorders. Among these technologies, we can consider that Autonomous Medication Management (GAM) is a group strategy with potential for emancipatory care, constituting a concrete tool to face the problem of medicalization of life. Thus, we aimed to investigate the limits and potentialities of GAM as a strategy of care and coping with medicalization in the context of the Family Health Strategy in a municipality in the interior of Rio Grande do Norte-RN. This is a research with a qualitative approach, which was developed around an intervention performed in the context of PHC, having as its ability to interfere in the reality studied and modify it, analyzing its effects for the participants. The instruments used were: the realization of a GAM intervention group over eight months, observant participation, and the construction of narratives from the experience with the group. In addition, field diaries and audio recording were used to record the experiment. The GAM group consisted of FHS users who make use of psychotropic drugs as well as members of the local NASF-AB team. For the constitution of the corpus of analysis the audio transcription records of the meetings, the researcher's field diaries and validated collective narratives were used. The results show that the process of medication permeates the practices of professionals and is configured as the main offer of care, the demands of psychic \ ethical-political suffering of women users in the FHS, who use psychiatric drugs as silencers of their anxieties associated with the female condition. and being a woman in her concrete realities due. The experience with GAM has shown to be a potentiator of demedicalizing actions, pointing out ways to incorporate new relationships and social dynamics in the territory. It was shown as a participative and reflective methodology with the ability to trigger self-knowledge, autonomy, and action power for all subjects. Its use promoted the expansion of dialogue, the exchange of experiences with the use of medication, building meaningful experiences in the different dimensions of people's lives: social, family and individual. The GAM also proved to be potent to establish health promotion spaces in the FHS, considering that the GAM guide was thus constituted as a group facilitator tool in this context. We conclude that GAM has strategic potential to face the medicalization of life in the FHS, as well as a care and attention tool for mental health production in PHC.