Responsabilidade e reforma psiquiátrica brasileira: sobre a produção de engajamento, implicação e vínculo nas práticas de atenção psicossocial

Abstract

In view of the numerous 'responsibility calls' appealed by practitioners and social sectors in the recent scenario of the Brazilían Psychíatric Reform, the present dissertation aims at outliníng discourses and practices on the notíon of responsíbilíty dísposed ín the field of mental health. The "shift of responsibility from service to terrítory', the 'íncrease of professional' s responsibility for their working process', and the 'possíbility of an individual be solely accountable for their conditiou' are discourses conveyed by diverse disciplines and theories, namely psychoanalysis, public health, and ínstítutional analysis, in related practicíng fields líke those mental health and collective health cover. Such discourses lead onto a very particular social and hístorical moment ín Brazil. lt ís belíeved that decentralization - justified by public health policies - develops ínto a process of 'transference of responsibílity to local uníts with concentration of power at core levei'. Thal relatíonship between State and the Civil Society establíshes a conflict between tasks and administrative resources very clear ín the so called 'partnerships' with lhe community. Just like at the early stages of Psychiatry and íts lnstitutions, the relationship between sectors and social practitioners, so as to look after insane people, became acute. Medicine should take control of the social mandate and legítímate a technícal action over the mentally ili patients. Instead, family and community are called at ali costs to share responsibilities leading to a citizenshíp stature and to a degree of independence available to the patient. Practices on the concept of responsibility are performed at the Psychosocial Attention Centers where every debate about the 'reference technicían' is a model in the process of negotíation, division and dístribution of mental health related tasks among professionals, relatives, users and members of the community. Commítment, bond, and involvement, as well as medíation, are techniques whose therapeutícal and admínistrative functions are conciliated.