“A culpa é da mãe?”: vozes de mulheres de um município da Baixada Fluminense sobre a prescrição de psicotrópicos para seus filhos pequenos

Abstract

This dissertation investigated the phenomenon of the demand for psychotropic prescription for young children from the perspective of mothers. As theoretical support, a brief historiography of child psychiatry and its relationship with the medicalization and medicamentation of everyday life was conducted, as well as an analysis of the role of science and medical power in constructing a moral judgment around biopolitical projects concerning motherhood and the care of young children. The main research topics included the mothers' participation in the process of seeking specialized care, mothers' expectations regarding the diagnoses of their children, demands and expectations of mothers regarding the use of psychotropics, and mapping the care network and its relationship with treatment. We explored these issues through the analysis of semi-structured interviews with mothers who underwent the initial reception at the Child and Adolescent Psychosocial Care Center (CAPSi) in São João de Meriti, in the Baixada Fluminense region. Mothers of children under six years old who used psychotropics were included in this sample. In this sample, the difficulty of sharing the care of their children with the family, and especially with the State, and the difficulty of caring for these children amid material precariousness favored an early search for care. The interviewees complained about a significant difficulty in accessing mental health specialists. Almost all resorted to private services, which proved not to be a viable long-term health access alternative. The appointments were described as very fast, with insufficient information exchange. Mothers demanded some way to reduce symptoms that hindered care or the division of care with their children, as well as guidance on their development. The responses from professionals were generally standardized and impersonal, including instant diagnoses, medication prescriptions, and referrals to non-pharmacological interventions. The attempt to strictly follow all these prescriptions left the interviewees even more frustrated and overwhelmed. Most mothers were dissatisfied with the effects of medications, and the explanations from specialists about psychotropics were minimal, even considering short and long-term risks. Non-pharmacological interventions (mainly occupational therapy and speech therapy) were identified as the major solution to their children's condition. Few interlocutors had access to these interventions, causing them a feeling of powerlessness and guilt in the situation. The issue of the medicalization and medicamentation of the mental health of young children is also related to multiple social oppressions. Therefore, measures that reduce these forms of oppression, such as social inequality, violence, sexism, racism, and state neglect, are essential in alleviating the issue. Strengthening the Psychosocial Care Network is also necessary to facilitate access to guidance and therapeutic resources, as well as to promote less medicalizing approaches to issues related to child development.