A transinstitucionalização no caso do fechamento da Casa de Saúde Dr. Eiras- Paracambi: uma questão paradoxal

Abstract

The present study aimed to analyze the closing process of the Casa de Saúde Dr. Eiras-Paracambi, a private psychiatric clinic that has been in a closing process for 12 years and effectively closed in March 2012. It involved the state s mental health management, the Paracambi s local government, the local governments that had interned patients, federal and state Public Ministry and the technical Department of Mental Health, on the Health Ministry . This research tries to analyze the policy responses that the city of Rio de Janeiro, which had the largest number of hospitalization, articulated to the citizens who were interned in this institution, focusing on transinstitutionalization. That is, the transfering of patients from the Casa de Saúde Dr. Eiras-Paracambi to other institutions: psychiatric or clinics. We tried to understand why this response was considered and how the patients passage was made from Casa de Saúde Dr Eiras- Paracambi to others institutions and which are the prospects for continued monitoring of transinstitutionalized cases. The research was divided into two phases, in both were made semistructured interviews. The first phase starts from collecting speeches of the managers, in a general view of the process, including investigating the participation of other municipalities. The second phase, stood on the professionals experience who work or worked more directly with patients transferred in the municipality of Rio de Janeiro. The institutions chosen for the second phase were Instituto Municipal Nise da Silveira and the CAPS Torquato Neto. We note that apart from different senses given to deinstitutionalization (dehospitalization, lack of assistance; deconstruction, new institutions and treatment intentionality), we can speak of various transinstitutionalization types: to hospital or other establishment for asylum, to private or public establishment, to psychiatric institution or clinical. The theme of transinstitutionalization was approached as a paradox, overcoming the dichotomy problem-solution.