É navegando que se faz a navegação: travessias desinstitucionalizantes em um hospital de custódia e tratamento psiquiátrico

Abstract

The Brazilian Psychiatric Reform developed new paradigms about madness through a deinstitutionalization project, however, care aimed at people in psychological distress who came into conflict with the law is thought of through long-term hospitalization, called a security measure . The judicial asylum, Hospital for Custody and Psychiatric Treatment, is the place responsible for complying with the execution of the detention security measure, which can last in perpetuity, given that there is no legal provision regarding a maximum time limit. Therefore, this study arises from the following questions: What would be the flows and obstacles that could arise during the construction of a policy of deinstitutionalization of security measures in the state of Rio Grande do Norte? How to articulate the feasibility of the construction and implementation of this policy? This research has the general objective of discussing the process of institutionalizing security measures in the state of Rio Grande do Norte in terms of its historical, political and institutional aspects. As specific objectives, we have: a) monitor compliance with the security measure, observing institutional routines and mental health practices; b) know the flows and possible obstacles to the deinstitutionalization of the security measure; and c) construct and propose strategies aimed at developing a care policy for subjects in psychological distress subject to security measures. This is a qualitative study carried out through two methodological procedures: a) documentary research in newspapers from the time of the creation of the judicial asylum in Natal; b) institutionalist cartographic intervention research, carried out between 2019 and 2022. Regarding the intervention, we used the following resources: training meetings, photography workshops and the production of a documentary film. The following participated in the intervention: professionals who work and people who are complying with security measures in the Psychiatric Custody and Treatment Unit; professionals who work in the psychosocial care network; legal operators and researchers. The data analyzed from an institutionalist perspective highlighted four analyzers: a) the double hospital-prison; b) the body in living and dead flesh; c) expertise: key that locks and unlocks; d) perverse invisibility and the policy of deinstitutionalization. The images, naked and intolerable, revealed the horrors of the imprisonment of “crazy criminals”, in times of fascist government and setbacks in antiasylum policy. The research demonstrated that custody in a judicial asylum criminalizes the many vulnerabilities of the subject in psychological distress, making it necessary to reformulate the practices carried out by forensic psychiatric expertise, in order to replace the presumption of dangerousness with the presumption of sociability, so that the expertise can ascertain the power of sociability. The training meetings made it possible to articulate the network in promoting discussion about the urgent need to deinstitutionalize the security measure, understanding that it is not limited to the closure of judicial asylums, but represents the breaking of the segregating structures that form mental asylums that sentence bodies to perpetual imprisonment. It is expected that the deinstitutionalizing devices will enable the opening of knowledge and the sharing of the sensitive in the visible order, making the judicial asylum appear in scenarios that had no visibility, bringing the struggle and the place occupied by bodies in psychological suffering into conflict with the law. In this sense, the thesis research contributes to the anti-asylum movement in the state of Rio Grande do Norte, mainly to the Anti-Asylum Policy of the Judiciary, a process of deinstitutionalization of the security measure currently underway, triggered by federal and state legislation, published at the beginning of the year 2023.