Integralidade e humanização em saúde mental : experiências de usuários em dois centros de atenção psicossocial

Abstract

The implementation of public mental health policies in the context of the Unified Health System (SUS), based on the precepts of the Psychiatric Reform, has generated new challenges for the mental health area such as the deployment of territorial and substitutive networks aiming the overcoming of the hospital-centered model, the development of the citizenship and the creation of a new social site for experiencing the psychic distress. To guarantee the materiality of changes, it is necessary the effective participation of users in the evaluation of mental health programs and services. Thus, the current research aims to understand the user experiences of two CAPS (Center for Psychosocial Care) in the Fortaleza city, concerning to the care provided by professionals, highlighting the dimensions comprehensiveness and the humanization on the health care. Regarding the methodology of this research, the choice for the qualitative approach is related to the ontological nature of the research object because this nature is pervaded by meanings which the users pose on their experiences on health care services and the way how they understand and interpret such care practices. The techniques used to obtain the empirical material were the detailed interview and the unstructured observation, in a time period of two months, from July to December 20011. The data were analyzed and interpreted under the perspective of the Gadamer´s critique hermeneutics whose method assumes the inter-subjectivity in the interconnection with the materiality to which it binds in a dialectic manner. The results revealed three central themes which constitute the Network of Meanings: A) The experiences on therapeutics itinerary; B) the user perception on the services, C) The quality of the care. We highlight the impact of the distinct models, hospital-centered and psychosocial, in the experience lived by distinct CAPS users. We also observed that the user perceive the embracement, the resolvability, the ambience, the good interaction between professionals and users, the monitoring of medicines and the humanization as the main aspects concerning to the quality of mental health care, although such issues had presented themselves in a singular way in the two CAPS investigated. We conclude that, despite some obstacle, the aspects of care pointed by users of the distinct CAPS corroborate the ideals of the Psychiatric Reform and signalize that the reorientation of the health care model already makes capillary in the daily care practices.