"Manter o paciente sempre estabilizado": reflexões sobre o cuidado em saúde mental em um centro de atenção psicossocial

Abstract

In view of the consequences of the treatment offered in asylums, which labeled the insane and subjected them to the institution's violence, suffering and alienation, the Psychiatric Reform and the process of deinstitutionalization are developed taking into account the transformation of this form of treatment, comprising the care in the territory in dialogue with the networks. However, the production of mental health care is crossed by challenges in implementing policies and initiatives aimed at the social reintegration of users, involving their life projects, actions are still fragmented or do not materialize. Therefore, this study aims to analyze how the mental health care production process takes place and its relationship with the territory in a Psychosocial Care Center (CAPS) II located in the interior of Rio Grande do Norte (RN), from the perspectives of service workers. This is a qualitative intervention-research that uses Institutional Analysis. It was developed through the following steps: conducting a conversation with professionals; participant-observation on days of collective activities; and the use of a research diary to facilitate recording and reflections resulting from contact with the field. Ethical aspects were complied with in accordance with Resolution nº 510/2016 - National Health Council, after the project was duly submitted and approved by the Ethics and Research Committee (CEP) of the Faculty of Health Sciences of Trairí (FACISA/UFRN), under CAAE opinion: 62774222.2.0000.5568. The data constructed from the researcher's presence in the field, in the investigation situation, were organized into 4 (four) thematic axes: The order, the demands and the research process; “Function is of paramount importance”: functioning of CAPS II; “It is a reality of every interior to have a character that is labeled as crazy”: experiences and perspectives on madness; “Keep the patient stabilized at all times”: care processes and the relationship between the CAPS and the territory. It is concluded that the aforementioned CAPS II presents its care production crossed by the asylum and asylum logic of closing the service in itself and is based on the pathologization of users. Thus, there is a lack of openness for the production of care in the territory, as well as failures in articulation with the users' networks and, therefore, in the process of social reintegration, so that care is limited to the walls of the service.