Sexualidade e saúde mental: construindo sentidos entre pessoas usuárias de um CAPS

When expressed by mental health services users, sexuality is typically denied by professionals, viewed as another symptom or as if these people are not capable of practicing it. Once Brazilian health professionals haven’t shown lots of investment in this theme, and few are the studies in this field, it is necessary the attention to be focused on researches involving this public. Therefore, the main goal of this study was understand the meanings of sexuality of the mental health services users, which were negotiated in sexuality workshops. The secondary goals were: a) understand the meanings of themes about sexuality brought by users through their experiences of everyday life; b) to evaluate the facilitating experience of the workshops on sexuality at CAPS. Thus, 10 workshops on sexuality were held, with an average of an hour and twenty minutes each, distributed from December 2014 and April 2015. There were 43 participants, 29 women and 14 men. The meetings had the following central themes: sexuality; sexuality and mental health; myths, beliefs and sexual taboos; gender identity; sexual orientation; sexual and reproductive rights; safe sex; and STD/AIDS. The data collection was through audio-recording of these meetings. Later, was made the transcript of the workshops, a careful reading of these transcripts and then its analysis. It was identified categories to analyze the interfaces that permeate the focus of the study. Initially, the categories relating to mental health and sexuality: meanings about sexuality; gender issues; gender and religion; sexual rights, STD/AIDS prevention and attention or denial of sexuality at CAPS. Later, those relating to the workshops facilitating process: challenges in facilitating the workshops; and the perception of the participants. A variety of meanings about sexuality could be noticed in the users’ statements, relating it more with affection and respect than with intercourse. The gender issues that emerged during the workshops were related to marital relationship, sexism, domestic violence, psychological violence and male and female roles in society. Moreover, were also revealed some situations that associated gender differences with religious issues, such as the submission of women and homosexuality. It was also noticed some experiences of the participants involving worrying situations of family violence, suicidal ideation and chemical castration, were often mismanaged or ignored by the service professionals. With regard to the facilitation of the workshops, it was possible to legitimize it as places where users were able to talk openly about the suggested themes and highlight its importance to the study site. Besides, it’s possible to list a few challenges of its facilitation in a mental health service, which was in general positively evaluated by the participants. Thus, the research highlights the need for sexuality theme discussion in mental health services, in order to understand, discuss and inform the users. Also, it’s important to problematize the stigma created in the theme relation with the users, the professionals and the society, working its specificities and avoiding a pathological bias.

“É acompanhante ou usuária?” Implicações sobre a posição da família no atendimento a crianças e adolescentes em um Centro de Atenção Psicossocial da Infância e Adolescência - CAPSi

This study emerged and founded itself with the aim to analyze the position taken by the family – and the implications in this subjective area – in attending children and adolescents in a Childhood Psychosocial Care Center (CAPSi). A secondary goal has come up as the comprehension surrounding the institutional representation made about the family and the service offered to children, adolescents and relatives. For such, the historical perspective on the relation between the State (laws and institutions) and the family was resumed, and the understanding of how it was reconciled by the medical knowledge and attended the ideological and political means. The social and ideological transformations of the 20th century culminated in the need of change required by the Psychiatric Reform and the achievement of patients on the right to return home and to their families. This new situation, permeated by the attempt of building an assistance model in Mental Health, presented a peculiarity–the close relationship between family and Mental Health services. The observations and conversations at CAPSi that were the investigation objects in this research, intended to learn on the quotidian of families and the possible treatment alternatives that would take into account the family circumstances. Conceiving the status of the families in Mental Health services is a germinal matter yet to be adjusted among the active knowledge in the post-Reform devices. The discussion about the family bonds, anchored in the theoretical perspective of Binding Psychoanalysis brought up elementary concepts such as psychic heritage, denial pact, unconscious alliances, the familiar psychic set, among other. The concept of family organizer helped to think of the family trajectories and stablishes a sort of identity for the family, as well as interferes in the establishment of its boundaries. The family path within the institution, as well as the status they establish facing the institutional approach, reflect the ghosts and the organizers shared by the group-family. It follows that the family is an important protagonist to be considered in the current therapeutic and political processes and, thus, is key to welcome the family bonds for the alliances act over the affective destinations, as well as try to remain sealed from the proposed changes.

Internação involuntária e o abuso de substâncias psicoativas - o pathos familiar

The use and abuse of Psychoactive Substances (PAS) in contemporaneity corresponds to a social issue and a public health issue. Few social phenomena entail more costs with justice and health, family difficulties, and appearances in the media than the PAS abuse comsumption. The government power has been facing this situation allocating investments and developing public policies. Despite the current Mental Health Policy, based on the principles of Psychiatric Reform that prioritizes outpatient services, the number of investments from various government spheres and families requests for admissions continue increasing. This study aimed to understand the pathos experienced by an individual toward the involuntary internment of a family member who is an abusive user of PAS. The research also aimed to investigate what led that individual to choose this type of treatment. The Psychoanalysis was the theoretical basis of this work, and the exercise of the psychoanalytic method, from the collection of bibliographic references up to the interpretation of the semi-structured interview, conducted in depth, was intended. The findings of this research gave us the oportunity of thinking about how the social callings to the family were made, especially in regard of atention and care with their family members who are user of PAS and how it affects this family individual. It also allowed to discuss how the public policies that preconize involuntary internment, affectivity, prohibitionist and mono-disciplinarity – that cross the State in the attention given to this issue – are formulated and implemented. The interview analysis showed us how happen the agencying of pathos, the libidinal aspects of joy and guilt, the desire to punish and atonement, working in family relations and in caring relations, especially in the decision for involuntary internment. The survey also made possible to understand how a mother, facing the chaotic scene of public health, helpless, finds in the involuntary internment a way to reverberate her affections.