Interface entre políticas públicas de saúde mental e economia solidária: a inserção socioprodutiva de pessoas com transtornos mentais

A interface trabalho e loucura têm sido construída e reconstruída ao longo da história, diante disto, o uso do trabalho não se constitui uma novidade no campo da saúde mental, ele está relacionado ao nascimento da psiquiatria, em um contexto de transformações das relações de produção, com a justificativa e finalidade de controle social, exploração de mão de obra e tratamento moral.No entanto, a partir do Processo de Reforma Psiquiátrica o trabalho entra em cena sob novas perspectivas. Nesse sentido, o presente estudo aborda a relação entre as políticas de saúde mental em que o trabalho é associado à economia solidária, a fim de compreender o sentido atribuído ao trabalho relacionado, buscando identificar suas práticas de inserção socioprodutiva e como é incorporado ao campo da saúde mental no Estado do Pará. Trata-se de uma pesquisa qualitativa, com base em entrevistas, observações in locos, levantamento de material documental e institucional. Paralelamente, efetivouse o tratamento do material recolhido, com o intuito de ordenar os dados obtidos, de evidenciar as experiências observadas por meios das oficinas de trabalho e/ou produção desenvolvidas nos serviços substitutivos, bem como, por meio das associações e cooperativas. Obteve-se como resultado as atividades sociais e produtivas relacionadas à saúde mental fazem parte dos serviços desenvolvidos nos CAPS, mas também são incentivadas a partir desses espaços como é o caso da Brilho e Luz, única associação de pessoas com transtornos mentais. Malgrado, se mostrarem incipientes e frágeis em sua constituição, necessitando de infraestrutura adequada e recursos, portanto, sem possibilidade de autonomia e independência em relação aos seus parceiros, principalmente governamentais, verifiquem-se aspectos positivos no âmbito individual das pessoas inseridas. Importa ressaltar que são experiências recentes no Brasil, sobretudo, no estado do Pará enquanto políticas públicas de saúde mental em interface com a economia solidária, constituindo-se em um processo em construção.

A interdisciplinaridade na atenção psicossocial: um olhar fotográfico sobre a psiquiatria

Pós-graduação em Psicologia - FCLAS

O encontro da loucura com o trabalho na economia solidária: a produção de práxis de pré-incubagem através do dispositivo intercessor na saúde mental

Pós-graduação em Psicologia - FCLAS

O trabalho como estratégia de atenção em saúde mental: cartografias do conceito Trabalho nas políticas públicas de saúde

Pós-graduação em Psicologia - FCLAS

Outcome of the agrarian reform in Brazil during the last two decades

The agrarian reform allows for land redistribution and gives rural workers the opportunity to develop their life projects, rescuing the dignity of a historically excluded population. The conquest of the land carries significances that span from the rescue of citizenship to the improvement of living conditions due to the acquisition of goods, products and services. It is pointed out that in Brazil there still exists a marked concentration of large-landed estates. In this sense, this work had the objective of analyzing the Brazilian agrarian reform process during the last two decades. In this period the country had three Presidents, two of them elected with the support of the Rural Landless Workers Movement, increasing the expectations in relation to the fulfillment of the agrarian reform. The advances in the policies of rural settlements are notable; however, the structure of large-land estates remains unaltered. In the last two years (2011 and 2012) the number of settled families, as well as the number of settlements accomplished, were the worst since 2006. The priority of the current government is the eradication of extreme poverty and, in this sense, the agrarian reform becomes an essential policy to contribute to such goal, since with the distribution of the property of the land also diminishes the concentration of wealth.

O sujeito-comprimido

Is it possible to encapsulate in a pill the benefits of an analytical treatment? Quickly suspending the symptoms? Since the nineteenth century psychiatry has offered to the so called mentally ill "medieval forms" of treatment, as is the case of institutional admissions, the straightjacket, lobotomies, shock treatments, etc. What has changed since the mid-twentieth century advent of chlorpromazine, the first psychoactive drug, and the "psychopharmacological revolution"? Today with the Psychiatric Reform mental institutions admissions are being gradually abandoned, yet we see the rise of psychoactive drugs as protagonists in mental health treatment. This theoretical essay is an extension of a master's thesis in progress on the long-term use of psychotropic drugs. It falls within the field of mental health, specifically in the debate on the medicalization of society in contemporary processes of subjectivation of the psychiatric clinics and the treatment modalities currently offered to individuals in their suffering-existence. Thus, we seek to problematize this degrading psychiatric clinics, which produces what we call the pill-subject.

O trabalho como dispositivo de atenção em saúde mental: trajetória histórica e reflexões sobre sua atual utilização

The partnership between Mental Health (MH) and work is present throughout the history of psychiatry. Capitalist society has used and uses the fitness or unfitness for work not only as one of the elements to the definition of "normality", but also as a treatment strategy. In this perspective, one can find a position healing and, more recently, a different proposal put forward by the psychiatric reform that considers also make / produce, the construction of meaning in the work as crucial for subjectivity. This sense is present in therapeutic workshops that seek to value the uniqueness, not to override the differences. The objective of this paper is to reflect on the relationship between Attention in SM / Work. Initially presents three theses, from which this relationship is built historically: 1 - Work as a means of avoiding idleness returning productively to society; 2 - Work as a healing practice, from the prescription, and 3 - Work as a strategy for care and social inclusion. Below, we discuss some questions about therapeutic workshops and income generation in the mental health care as a device for attention and social inclusion.

Evaluation of the relationship between education and sustainability in peasant movements: The experience of the National Education Program in Agrarian Reform

Brazil is one of the largest agricultural producers in the world. However, its agrarian composition is based on two markedly different production models, particularly in relation to sustainability: a peasant family agriculture, which plays an important role in food production for domestic consumption and advocates agro-ecological practises; and agribusiness, the politically and economically hegemonic model that produces commodities for export based on monoculture and intensive use of pesticides. Therefore, in order to create the means to develop peasant lands, social movements and peasants have engaged themselves politically and defended an education model grounded in sustainable practises of production and social organisation. Taking this into account, the main purpose of this paper is to analyse and assess the Brazilian experience of integration between education and sustainability, in the National Education Program in Agrarian Reform (PRONERA). To accomplish this aim, a survey with a semi-structured questionnaire was carried out among teachers, students, monitors, and coordinators of the course offered by PRONERA. The surveys showed that the courses are promoting the concepts of sustainability among peasants. However, many adjustments need to be taken into consideration during the planning process for the next courses offered by PRONERA.

A configuração de forças na constituição histórica do trabalho como estratégia de cuidado em saúde mental: problematizações foucaultianas

Investigated in this paper, as contributions to Foucault's genealogy of knowledge, the historical constitution of the joint activities between Work and Care in Mental Health (called Therapeutic Workshops, among other names) in their different purposes and dimensions that contributed to the production care of patients with psychological distress at different times. History is here understood as a multiplicity (and nonlinearity) of time series and various blending and shuffleforming speeches as truths. In conjunction we have discussed, we conclude that the work as a therapeutic modality in nursing homes, there emerged in the world of psychiatry, but of capitalism. Associated with measures of occupation "empty minds" of misfits, later earned the position of an instrument of discipline and social regulation. With the Psychiatric Reform, activities Work in Mental Health have been re-invented as spaces enablers of access to citizenship and contractuality social network users.

World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for Biological Treatment of Schizophrenia, Part 1: Update 2012 on the acute treatment of schizophrenia and the management of treatment resistance

These updated guidelines are based on a first edition of the World Federation of Societies of Biological Psychiatry Guidelines for Biological Treatment of Schizophrenia published in 2005. For this 2012 revision, all available publications pertaining to the biological treatment of schizophrenia were reviewed systematically to allow for an evidence-based update. These guidelines provide evidence-based practice recommendations that are clinically and scientifically meaningful and these guidelines are intended to be used by all physicians diagnosing and treating people suffering from schizophrenia. Based on the first version of these guidelines, a systematic review of the MEDLINE/PUBMED database and the Cochrane Library, in addition to data extraction from national treatment guidelines, has been performed for this update. The identified literature was evaluated with respect to the strength of evidence for its efficacy and then categorised into six levels of evidence (A-F; Bandelow et al. 2008b, World J Biol Psychiatry 9: 242). This first part of the updated guidelines covers the general descriptions of antipsychotics and their side effects, the biological treatment of acute schizophrenia and the management of treatment-resistant schizophrenia.

Stigma and higher rates of psychiatric re-hospitalization: Sao Paulo public mental health system

Objective: The aim of this study was to assess re-hospitalization rates of individuals with psychosis and bipolar disorder and to study determinants of readmission. Methods: Prospective observational study, conducted in Sao Paulo, Brazil. One hundred-sixty-nine individuals with bipolar and psychotic disorder in need of hospitalization in the public mental health system were followed for 12 months after discharge. Their families were contacted by telephone and interviews were conducted at 1, 2, 6 and 12 months post-discharge to evaluate readmission rates and factors related. Results: One-year re-hospitalization rate was of 42.6%. Physical restraint during hospital stay was a risk factor (OR = 5.4-10.5) for readmission in most models. Not attending consultations after discharge was related to the 12-month point readmission (OR = 8.5, 95% CI 2.3-31.2) and to the survival model (OR = 3.2, 95% CI 1.5-7.2). Number of previous admissions was a risk factor for the survival model (OR = 6.6-11.9). Family's agreement with permanent hospitalization of individuals with mental illness was the predictor associated to readmission in all models (OR = 3.5-10.9) and resulted in shorter survival time to readmission; those readmitted were stereotyped as dangerous and unhealthy. Conclusions: Family's stigma towards mental illness might contribute to the increase in readmission rates of their relatives with psychiatric disorders. More studies should be conducted to depict mechanisms by which stigma increases re-hospitalization rates.

Tracking the impact of translational research in psychiatry: state of the art and perspectives

Personalized treatments have become a primary goal in translational psychiatric research. They include the identification of neural circuits associated with psychiatric disorders and definition of treatment according to individual characteristics. Many new tools and technologies have been developed but further efforts are required to provide clues on how these scientific advances in psychiatry may be translated into more effective therapeutic approaches. Obstacles to the progress of translational psychiatry also involve numerous scientific, financial, ethical, logistics and regulatory aspects. Also, the goal of DSM-5 to expand “signs and symptoms” classification to incorporate biological measures may help the development of new multifactorial and dimensional models able to better understand the pathophysiology of psychiatric disorders and develop improved treatments. Finally, a better understanding on the significant response variability, cognitive functioning, role of comorbidities and treatment-resistant cases are critical for the development of prevention and intervention strategies that are more effective.

Environmental management reform for sustainable farming, fisheries and aquaculture: state of the art review

FOOD-CT-2007-036298: AquAgriS. Project co-funded by the European Commission within the Sixth Framework (2002-2006)