Entre o registro e a denúncia: práticas nos CAPS durante a pandemia de COVID-19

Abstract

The pandemic has called into question the logic of psychosocial care, which is fundamentally based on proximity and in-person contact. Social distancing has become an imposed reality, with a direct impact on the maintenance of therapeutic bonds and access to necessary care. Fear of COVID-19 transmission, coupled with difficulties in accessing public transportation and the premise of distancing, has reduced users' contact with healthcare services, which were undergoing a process of adaptation and restructuring to meet the challenges posed by the new health reality. This study investigated care practices developed in CAPS (Psychosocial Care Centers) during the COVID-19 pandemic period based on experience reports produced between 2020 and 2022, with the aim of accessing, gathering, and systematizing the records available online in this format; identifying whether recommendations for home isolation and social distancing are seen as obstacles to the exercise of care in the community and examining which strategies CAPS employ to connect users to the service. The reports were collected through research in different databases. The initial sample included 415 papers, which were subsequently reduced to 23. Inclusion criteria for the research encompass experiential reports from 2020 to 2022 that address issues related to CAPS. Studies prior to 2020 or after 2022, abstracts or descriptions lacking sufficient information for analysis, and texts not centrally focused on the COVID-19 pandemic or CAPS were excluded. WHO health guidelines emphasize the importance of physical distancing, not social distancing. Concerning the specific effect of this recommendation on CAPS routines, it is observed that some in-person activities were halted, while others were maintained. The practices involved promoting, preventing, and recovering mental health, pointing towards remote care methods aimed at both preventing health issues and protecting users during the health crisis. Additionally, these care practices can be considered as soft-hard technologies, as they indicate the need to maintain connections to sustain therapeutic relationships. Simultaneously, the reports expose the negligence resulting from the country's denialist policy in the face of the pandemic, leading to service closures, increased demand for hospital beds, and the lack of personal protective equipment (PPE). The hospital-centered biomedical model proves inadequate in addressing the crisis on various fronts, underscoring the importance of a universal system that integrates soft care technologies into a more effective framework constructed based on the demands raised by users, groups, and other actors in the social realm within the community. The reports underscore the importance of soft and soft-hard technologies in mental health care and the importance of a community-oriented and territorially connected response to the pandemic.