Práticas discursivas no cotidiano e a construção de sentidos sobre o cuidado em saúde mental

Abstract

The interest in this research theme stems from the subjective implication of the author, built in her historical and cultural context, and for her professional performance in the practice of mental health care, in a CAPS from Manaus city. The present research aims to analyze the constructed senses on the daily care of a substitutive service in Manaus, from changes in the public policy of mental health care, realizing the complexity and the challenges of the demands accompanied by the interdisciplinary team, of this specialized service, and searching for possibilities that prove strong in the care. The theoretical framework used addresses the paradigmatic changes in the model of mental health care. It supports the process of Brazilian psychiatric reform, with the inclusion of psychosocial factors in health care relationships, and the practice of psychosocial clinic, which is based both on interdisciplinary work and comprehensive care network for the autonomy production. Beginning from this background, we trace the historical path of change in the model of mental health care practices, in both general context and in Manaus, which reflects a delay in the implementation of the policy and RAPS; as well as the appropriation of the actions by the state; and absence of the municipal actors in their execution, characterizing a disjointed network and an insufficient number of services. Herein, the methodological basis is constituted from the constructivist perspective, language centered, in which every day discursive practices are constructors of meanings. Then, participant observation was carried out in the micro places, where these practices are constructed in the daily life. It were collected fictional narratives constructed from the lived, spoken and heard on the field of research, in order to know the meanings of the changes in the mental health care model, for the life of the subjects/users and for the practices of the professionals working on RAPS services. With narratives as units of analysis, it is reflected on the experience of suffering related to the condition of exclusion and social inequality experienced by the subjects/users and on the contradictions that are present in the daily life, considering the challenges and the potentialities for the effectiveness of the psychosocial care.