A palavra cantada nos espaços intersubjetivos de um centro de atenção psisossocial do município do Natal/RN

The psychiatric care and mental health are undergoing constant change over the History. The Brazilian Psychiatric Reform, which brings up the deinstitutionalization as a structuring in the restorative care process. The Reform has as one of the mainly substitutive services the Centers for Psychosocial Care (CAPS), which work from the Singular Therapeutic Project (PTS) in order to restore the autonomy and restore the dignity of users. The therapeutic workshop is some of the resources used and work several kinds of activities as: writing, handcraft, music, poetry, and so forth. This study set up to apprehend the social representations of helping of the music workshop carried out in the CAPS II east of Natal/RN, from the reports given by the participants of the workshop, using the focal group as technique. This is a descriptive exploratory study with a qualitative approach. A total of 16 users participated in four musical therapeutic workshops from April to May 2010. The study was approved by the Ethics and Research Committee of UFRN. The discursive material from the workshop was submitted to the informational resource of Analyse Lexicale par Contexte d um Ensemble de Segments de Texte, ALCESTE, and analyzed based on the Theory of Representations and the Central Core Theory. The majority of subjects were men (62.5%), single (62.5%), aged 40-49 years (37.6%) and elementary school level (56.2 %). The reports were transcribed and submitted to the classification system of ALCESTE, which elected the following categories: Category 1 - Experience in the Word Family Sung, Category 2 - Musical Experiences and Approaches, and Category 3 - Feelings and emotions evoked by music. The representation of these individuals is anchored in the experience they have with the CAPS, lived and socialized by common sense, through this particular social group workshop objectified in music therapy as a therapeutic modality enjoyable. The central core revealed the intrinsic relationship between users and the music, establishing a relationship of openness to use the same while its therapeutic use in workshops of substitute services for mental health. Peripherals elements issues are related to listen, share and experience music in the family. Intermediary Elements relate to the feelings and emotions evoked by music, given her close relationship with it. It was found in the study that music can be construed as an artifact of good therapeutic responsiveness to users, configuring it as an invigorating and enjoyable therapy, confirming the need for continuity of this activity, as well as its expansion into the service

O ambulatório de Saúde Mental no contexto da Reforma Psiquiátrica em Natal/RN

The years 1990 disclose the consolidation of the Brazilian Psychiatric Reform project, assumed as official politics by the Health Department, also stirring up discussions, lines of direction and new ways of care. Substitutive services to the psychiatric hospital as CAPS, conviviality centers, therapeutical residences and ambulatory clinics are implemented. This work analyzes the relations that the Specialized Ambulatory Clinic of Ribeira establishes to the services of Mental Health of the public system in the city of Natal/RN, as well as its adjustment to the proposal of the Psychiatric Reform. Through semi-structured interviews and observation, it was possible to gather data which allowed picturing a general characterization of the service: activities, technical group, joint with other institutions, daily routine organization. Such institution develops activities that surpass the traditional character of a clinic- in other words, the psychological/medical appointments - and it mainly greets the ones proceeding from CAPS and psychiatric hospitals. It offers group activities, psychiatric appointments, therapeutical workshops, sheltering and strolls, among others. The institution is composed by a multi-professional team of psychiatrists, psychologists, occupational therapists, nurse s aide and art-educator. The joint of this service with others that make part of the Mental Health Assistance network in Natal is incipient. Due to this fact, some actions and activities that could and should be developed together are just not. Although facing difficulties, the professionals of the Ambulatory Clinic of Ribeira are able to achieve good results and establish care in Mental Health that prioritize sheltering, listening and respect to the user s individuality. The Ambulatory Clinic of Ribeira is organized according to the paradigm of the Psychiatric Reform. Therefore, it offers an attention that stimulates the re-socialization of the users and the exercise of the citizenship and autonomy of those

Estratégias de cuidado integral à saúde: os CAPS no processo de implementação do apoio matricial em Natal/RN

This study aims to analyzing the implementation of the Matrix Support proposal with professionals of Substitutive Services in Mental Health in the city of Natal/RN. The Matrix Support (MS) is an institutional arrangement which has been recently adopted by the Health Ministry, as an administrative strategy, for the construction of a wide care net in Mental Health, deviating the logic of indiscriminate follow-through changed by one of co-responsibility. In addition to this, its goal is to promote a major resolution as regards health assistance. Integral attention, as it is intended by the unique health system, may be reached by means of knowledge and practices interchange, establishing an interdisciplinary work logic, through an interconnected net of health services. For the accomplishment of this study, individual interviews of semi-structured character were used as instrument, with the coordinators and technical staff of the CAPs. The data collection was done in the following services: CAPS II ( East and West) and CAPS ad ( North and East), in the city of Natal/RN. The results point out that the CAPs to initiate of the discussion the process in the implementation of the MS aiming, to promote the reorganization and redefinition of the flow in the net, thus not acting in a fragmented way. Nevertheless, there is no effective articulation concerning the basic attention services, there is a major focus of the attention in mental health on the specialized services, little insertion in the territory and in the everyday life of the community

Ajuda mútua nos CAPS: o papel dos serviços no empoderamento dos usuários

The research objective is explore practices to mutual help between CAPS users from the east and west regions of the city of Natal, RN, in Brazil. In the mental health field, we observe the care from substitutive services is based on technical knowledge where the person of the mental health professional is predominant. The Brazilian psychiatry reform invests in equipments and mental health care protocols, but it is necessary to invest more vigorously in new strategies and actors capable of obtaining resources to achieve this goal, such as the users. If one cornerstone of the psychiatric reform consists of changing the type of relationship established with the person with mental disorders, why this relationship, nowadays, is still dominated by technique and unevenness, where on one side we have a person who knows something and who needs take care of someone, and on other side we have another who knows nothing and thus needs to be cared for? Starting from this problematization of the traditional methods of health/mental health care, an attempt was made to investigate in what ways the mutual help practices between people with mental disorders can realize potential avenues not yet explored within the scope of psychiatric reform. The objective of this research was to map possible mutual help practices among the users, and the technical understanding of such practices. For that, we took part in the daily activities of the CAPS, mapping the experiences of mutual help among users. In addition, we accompanied the users in external activities (such as return home, trips, etc), and we had roundtables with the professionals. The research was guided by theoretical methodological references of the institutional analysis. The results pointed to a lack of behaviors of mutual help or support among users, something that can probably be explained by the service work dynamics, as well as the relationship between technicians and users, which has a tendency to create hurdles for meetings among users, as well as being non-conducive to theirempowerment

Experiências maternas de perda de um filho com câncer infantil: uma compreensão fenomenológico-existencial

Death due to childhood cancer reflects an early outcome of life, which can cause a strong repercussion in the mother s existence - figure to whom the greatest part of responsibilities during the child s illness is commonly allocated. The aim of this study is to understand the experience of mothers who have lost a kid as a consequence of childhood cancer, approaching the personal senses of this fact. Following a qualitative research design, with an exploratory and comprehensive approach, the study used the narrative method, which was obtained from a semi-structured interview, as the data generation procedure. The research counted on the participation of three adult mothers who had lost their kids because of childhood cancer, after - at least - a six-month period of oncologic treatment. The proposal of analysis follows the parameters of the phenomenological method and the data are based on Martin Heidegger s existential analytic. The results were structured into three thematic axes: previous History, child illness and its repercussions; The network of support and care; Loss and after loss: facing and signifying. It was possible to comprehend that the emergence of cancer in childhood promotes, since the diagnosis, a disruption of everyday meanings, accentuating the fragile condition of human life. In this specific circumstance of childhood illness, all the participants restricted their possibilities of being-in-the-world, dedicating exclusively to the practice of maternity. Concerning their relationship with their children in treatment, the narratives unveiled, in a convergent manner, the existence of care in a substitutive mode. In the network of support - primarily constituted by family, the health team and the support institutions - the relations were marked by proximity and detachment movements. With the child s death, mothers began to live a way of being-with the absent child , ensuring the continuity of the relationship with the dead infant. From the results exposed above, we can understand the motherly mourn as a singular experience in constant resignification, in which the subjective time overlaps the cronological time. The increment of anguish, resulting from the mother s confrontation to the question of finitude, mobilizes a process of change in their way of being-in-the-world, promoting an openness to new possibilities in their lives. Singular attention to the mother, during the process of illness and child loss, turns out to be fundamental

O dispositivo alta nos Centros de Atenção Psicossocial/CAPS : loucura, vida cotidiana e organização social

The present paper proposes an analysis about the Brazilian Psychiatric Reform as a public policy and deriving from a research developed with the workers of a Psychosocial Attention Centre III (CAPS III) and the managers of the Psychosocial Attention Web (REAP) in Aracaju. This analysis is developed as an investigation of the discharge at those services, understood not as a procedure, but as a dispositive from which different elements can be articulated: users, knowledge, technical procedures, police measures, juridical decisions, laws, services edifying. This, form the background of the articulation between mental alienation and the subject of right alienation, in the ways through which this articulation develops to the relations between madness,citizenship, internment and substitutive practices. Our investigation about the discharge as a dispositive was built with some narrative constructions, as a discourse analysis inspired by Michel Foucault s method, from the perspective of some of the main dispositive operators: workers and managers. The main aspect observed were: the articulations built by the discharge as a dispositive based on two discursive grate, the Reform as a new treatment substituting internship, and the Reform as juridical insertion and users rights practice; the exercise of these discursive grades based on the workers and managers perspective; the transference of limitations and contradictions of these grades to the competence of the dispositive operators, emerged in an outstanding way, as sometimes those operators are liable for the emergent limitations and difficulties, and some other times they are restrained by their institutional role, which is to maintain the domination relations articulated by the dispositive; finally, some aspects extracted which the dispositive operators - when they were expected to act in a way to maintain certain power relations - were capable to resist, managing other power relations from the dispositive, that we call, as Agamben, dispositive profanity