Panorama das internações psiquiátricas de longa permanência e práticas de desinstitucionalização na cidade do Rio de Janeiro

Abstract

This research aimed to study about the hospitalization of people for a long time in psychiatric hospitals and actions planned to finish this condition in the city of Rio de Janeiro. Considering that the practices in mental health and general health were related to social, economic and political context, it is understood that the existence of the long-stay hospitalization in public psychiatric hospitals and private clinics - in association with public investments - have direct relation to the health policies that prevailed over time in the country and the specific work on this in the town. So, there is also the consideration that the Psychiatric Reform and its conceptual innovations have also been linked to a new era of health policies in the country after the entrance of SUS, a very different kind of policy which changes all practices in health. This system points to the directions of a universal health access, decentralized and hierarchical, allowing large changes in scenario assistance. Therefore, in this research we study the actions of deinstitutionalization in the city, taking as one of the first initiatives of the management reorganization of psychiatric care for the deployment of Poles of Emergency, a strategy of co-management of the Ministry of Health and Inamps yet in the 80s. Following this reorganization that resulted in greater regulation of the entrance door of psychiatric hospitalizations and fewer hospitalizations in private clinics, the municipality had its entrance as a manager in mental health in the city, as new actions taken. In studying these actions and strategies planned it was used semi-structured interviews with people who participated in the management initiatives in health in the city of Rio de Janeiro, and also, document analysis of Reports published by the Management Coordination Municipal Mental Health. In this study, we emphasized the power of public services to give directions and formulate public health policies. Also we highlight the importance of the work done to by the deconstruction of the asylum psychiatric when there are restrictions to answer to a social problem with psychiatric hospitalization or reduce psychiatric problems of many orders to this procedure.