O trabalho político do profissional de saúde mental em um processo de desinstitucionalização: um estudo sobre integralidade e reforma psiquiátrica

Abstract

The work intends to present a map of the activities performed by mental health professionals that assist the dwellers of the residential care homes in the municipal district of Carmo, State of Rio de Janeiro. These residences are part of a stage in the process of desinstitutionalisation of a state Psychiatry Hospital, an agricultural colony type, founded during the forties in the 20th century, and where about 280 inpatients lived. From 2003 on, when the hospital was closed under coordination of the state manager, and the resources were municipalised, a small part of the inpatients returned to their families, but the majority (about 160) were placed in care homes, scattered over country or urban district areas. Taking the task of social inclusiveness as the political bias of Brazilian Psichiatric Reform, day-to-day work of the multiprofessional team is focused. In this relational level, the text looks forward to conceptualise Politics and political work, through Arendt, Gramsci, Deleuze and Guattari s ideas, among others. And ergonomics enables a view to knowledge production, with its approach to human work. Based on a camp research, the map production reveals how politic task is performed, in the professionals activities, that means, in the micropolitics of professionals meetings with one another, with civil society and with the residents, where values of Psichiatric Reform are negotiated. In the end, it s a phase in a process, still half way between state and municipal administration, where the proposal is sustained by the administrators politic will, and, on its way to become hegemonic, must be discussed among professionals and civil society. The landscape is not homogeneous, and the dinamics reveal the diversity of understandings and interests. In the scenery of everyday work, concepts such as autonomy or citizenship are present on activities which are characteristic of city life, and they unfold over some themes, as the use of money, or the making and occupying of one s personal space. The experience of the professionals that work closer to the residentes, as the caretakers do, produces a technique of hearing and stimulation, which by no means admits unchangeable or preestablished rules. This group work, maker of nets and relying on interaction, is an indicator to integrality when Psychiatric Reform proposal is performed.